The Progressive Nature of Atrial Fibrillation:A Rationale for Early Restoration and Maintenance of Sinus Rhythm

Atrial fibrillation (AF) is the manifest outcome of a multifactorial, progressive disease process,secondarily or primarily involving the atrial chambers. The slowly progressive electrostructural alterations diffusely involve the atrial substrate and lead to persistent and permanent forms of AF. Although the progression of the AF disease process is variable and associated with the development of comorbid conditions, rhythm restoration therapies, particularly catheter ablation,provide higher acute and long-term success rates in paroxysmal than non-paroxysmal AF. This review of literature aims to discuss how early restoration and maintenance of sinus rhythm especially using novel approaches can influence the progressive nature of atrial fibrillation.