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Mechanisms of atrial fibrillation

Rohan S Wijesurendra1, Barbara Casadei1

  • 1Division of Cardiovascular Medicine, University of Oxford, Oxford, UK rohan.wijesurendra@cardiov.ox.ac.uk barbara.casadei@cardiov.ox.ac.uk.

Heart (British Cardiac Society)
|August 25, 2019
PubMed

Insights

Atrial fibrillation (AF) is a common heart rhythm disorder affecting millions globally. This review clarifies AF mechanisms, covering its pathophysiology, genetics, and links to other health issues for better treatment strategies.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Genetics

Background:

  • Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia, impacting over 33 million people worldwide.
  • AF significantly increases the risk of premature mortality, heart failure, stroke, and myocardial infarction.
  • Understanding AF pathophysiology is challenging due to its complexity and patient heterogeneity.

Purpose of the Study:

  • To provide a non-specialist summary of current knowledge on atrial fibrillation mechanisms.
  • To consolidate understanding of AF pathophysiology, including electrophysiological, structural, genetic, and comorbidity links.
  • To explore translational implications for AF rhythm control strategies.

Main Methods:

  • Review of existing literature on atrial fibrillation pathophysiology.
  • Synthesis of information on cellular, molecular, and electrophysiological changes in AF.
  • Analysis of genetic factors, comorbidities, and systemic influences on AF development.

Main Results:

  • AF results from complex pathophysiological processes with significant inter-individual variability.
  • Key factors include left atrial electrophysiological and structural changes, genetic predispositions, and systemic metabolic issues.
  • Comorbidities and broader health perturbations contribute to AF development.

Conclusions:

  • AF is a multifaceted arrhythmia with diverse underlying mechanisms.
  • A comprehensive understanding of AF pathophysiology is crucial for developing effective rhythm control strategies.
  • Future research should focus on personalized approaches based on individual patient heterogeneity.

Keywords:
atrial fibrillation

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