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Updated: Aug 27, 2026

High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation
Published on: July 29, 2011
[Atrial fibrillation]
Insights
Atrial fibrillation, a common heart rhythm disorder, increases with age and heart failure. Treatment involves anticoagulation or anti-aggregation, and managing heart rhythm or rate.
Area of Science:
- Cardiology
- Electrophysiology
Context:
- Atrial fibrillation is the most prevalent cardiac arrhythmia, with incidence rising significantly in older adults and those with heart failure.
- The condition's prevalence exceeds 6% in individuals over 80 and can reach 50% in severe heart failure cases (NYHA IV).
Purpose:
- To outline the diagnosis and therapeutic strategies for atrial fibrillation.
- To differentiate between anticoagulant and anti-aggregation treatments, and rhythm versus rate control.
Summary:
- Diagnosis relies on ECG and echocardiography. Therapy decisions hinge on anticoagulation/anti-aggregation and rhythm/rate control.
- Anticoagulation is crucial for most patients, especially before cardioversion. Anti-aggregation may suffice for low-risk individuals.
- Rhythm control via cardioversion is recommended for symptomatic patients; rate control is often safer for others, particularly the elderly.
Impact:
- Provides a concise overview of atrial fibrillation management for clinicians.
- Highlights the importance of individualized treatment strategies based on patient risk factors and symptoms.
- Emphasizes the role of anticoagulation and tailored rate or rhythm control in optimizing patient outcomes.
Abstract:
Atrial fibrilation is the most frequent arrhythmia, the occurrence increasing with age and associated diseases. The incidence at the age below 60 years is markedly lower than one per cent, whereas in persons above 80 years of age it exceeds six per cent. The occurrence in patients with heart failure is from 10% (NYHA II) up to 50% (NYHA IV). Atrial fibrillation is classified into that observed for the first time and permanent, respectively, while transient forms include paroxyzmal and persistent atrial fibrillation. The diagnosis is based on ECG recording, while echocardiography is most significant. The therapy includes two basic questions--anticoagulant or anti-aggregation treatment and the control of rhythm or frequency. The anticoagulant therapy should be introduced in all patients, where contraindications are not present, being necessary before every cardioversion, provided atrial fibrillation lasts more than two days. In patients without any heart disease and with a physiological echocardiogram it is possible to administer only anti-aggregation treatment. Cardioversion (the control of rhythm) is recommended to all symptomatic patients, in other cases and especially in older persons the control of frequency is safer and of more advantage. Electrical cardioversion is more effective that a pharmacological treatment, the sinus rhythm is preferably controlled by dofetilid, ibutilid, propafenon and amiodaron. For the control of heart rate beta-blockers, diltiazem, verapamil and digitalis are recommended.
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