[Atrial fibrillation in the era of catheter ablation]

Area of Science:

• Cardiology
• Electrophysiology
• Molecular Medicine

Context:

• Atrial fibrillation (AF) is the most common cardiac arrhythmia, significantly increasing morbidity and mortality.
• The pathophysiology of AF involves triggers and substrate, influenced by various modulating factors, with the most significant risk factor remaining unclear.
• Understanding AF's molecular and genetic underpinnings is crucial for effective prevention and treatment strategies.

Purpose:

• To explore the pathophysiology of atrial fibrillation, including molecular and genetic factors.
• To discuss current and emerging therapeutic strategies for atrial fibrillation, including pharmacological treatments and "upstream therapy" targeting atrial remodeling.
• To present the outcomes of catheter ablation procedures for atrial fibrillation performed at the Internal Cardiology Department of MU Medical Faculty and Faculty Hospital Brno.

Summary:

• Catheter ablation is currently the most effective treatment for atrial fibrillation.
• Successful ablation halts electrical, structural, and mechanical myocardial remodeling, enhances left ventricle function, and reduces thromboembolism risk to baseline levels.
• Restoration of sinus rhythm post-ablation initiates reverse remodeling, improving cardiac function.

Impact:

• Catheter ablation offers a definitive treatment for atrial fibrillation, significantly improving patient outcomes.
• Successful ablation normalizes thromboembolism risk, comparable to the general population.
• The procedure promotes myocardial functional and structural recovery, leading to improved overall cardiovascular health.