Atrial fibrillation: effects beyond the atrium?

Area of Science:

• Cardiology
• Electrophysiology
• Cardiovascular Research

Background:

• Atrial fibrillation (AF) is a common arrhythmia linked to heart failure, stroke, and increased mortality.
• Research traditionally focused on atrial remodeling, but AF's systemic effects are increasingly recognized.
• AF is associated with systemic inflammation, endothelial dysfunction, and adverse ventricular changes.

Purpose of the Study:

• To review molecular and in vivo evidence on AF's effects on the ventricular myocardium.
• To explore mechanisms linking AF to ventricular dysfunction.
• To discuss clinical implications, including rate versus rhythm control.

Main Methods:

• Review of molecular and in vivo studies on AF and ventricular myocardium.
• Exploration of potential mechanisms of ventricular involvement.
• Analysis of the relationship between AF, inflammation, and endothelial dysfunction.

Main Results:

• AF affects the left ventricle, causing diffuse fibrosis, focal scarring, and impaired perfusion.
• Systemic inflammation, endothelial/microvascular dysfunction play roles in AF's ventricular impact.
• Ventricular calcium handling and oxidative stress are affected by AF.

Conclusions:

• AF is a systemic disease with significant consequences for ventricular structure and function.
• Understanding these mechanisms is crucial for managing AF and its complications.
• Clinical strategies must consider AF's broader impact beyond the atria.