[Pathophysiology and clinical manifestations of atrial fibrillation]

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia among elderly people. The condition is frequently associated with structural heart disease, although a substantial number of patients have no underlying disease. Stretch in the pulmonary vein is considered to play the most important role in its pathogenesis, particularly in patients with hypertension and heart failure. The autonomic nervous system is known to contribute to its initiation. Based on its duration, AF can be classified into paroxysmal, persistent, and permanent, but its progression from the former to the latter is common over years. Palpitations are most frequently complained in paroxysmal AF, whereas absence of symptoms is not unusual in permanent AF. But regardless of types or symptoms of AF, AF is notorious for potentially causing stroke and heart failure, which increase morbidity and mortality.