Related Experiment Videos
Factors predisposing to the development of atrial fibrillation
1University of Marseille, School of Medicine, Chief Cardiology Division, Hôpital Nord, France.
Insights
Atrial fibrillation (AF) is often linked to underlying heart conditions like valvular disease and hypertension in about 70% of patients. However, about 30% of cases, known as lone AF, occur without detectable organic heart disease.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Atrial fibrillation (AF) is a common arrhythmia frequently associated with organic heart disease.
- Determining the causal relationship between AF and chronic conditions can be challenging.
- Approximately 70% of AF patients have underlying heart disease, while 30% experience lone AF.
Purpose of the Study:
- To review the diverse etiologies of atrial fibrillation.
- To differentiate between AF caused by organic heart disease and lone AF.
- To identify risk factors and associated conditions contributing to AF development.
Main Methods:
- Literature review of studies on atrial fibrillation etiologies and risk factors.
- Analysis of patient data associating AF with various cardiac and non-cardiac conditions.
- Categorization of AF causes into organic heart disease-related and idiopathic/lone AF.
Main Results:
- Common organic heart diseases linked to AF include valvular heart disease, coronary artery disease, and hypertension.
- Conditions like cardiac amyloidosis, hemochromatosis, and mitral valve prolapse can also present with AF.
- Lone AF occurs in about 30% of cases, with idiopathic AF excluding other specific causes like hyperthyroidism or preexcitation syndromes.
- Risk factors for AF include increasing age, valvular heart disease, congestive heart failure, hypertension, left ventricular hypertrophy, and diabetes.
Conclusions:
- Atrial fibrillation has multifactorial origins, commonly stemming from organic heart disease but also occurring independently.
- Accurate assessment of AF risk requires considering a wide range of potential etiologies and patient-specific factors.
- Further research is needed to clarify the interplay between various conditions and AF development.
Abstract:
Atrial fibrillation (AF) is in most patients (approximately 70%) associated with organic heart disease including valvular heart disease, coronary artery disease, hypertension, hypertrophic cardiomyopathy, dilated cardiomyopathy, and congenital heart disease, mostly atrial septal defect in adults. In many chronic conditions, determining whether AF is the result or is unrelated to the underlying heart disease, remains unclear. The list of possible etiologies also include cardiac amyloidosis, hemochromatosis and endomyocardial fibrosis. Other heart diseases, such as mitral valve prolapse (without mitral regurgitation), calcifications of the mitral annulus, atrial myxoma, pheochomocytoma, and idiopathic dilated right atrium may present with AF. Atrial fibrillation may occur in the absence of detectable organic heart disease, the so-called "lone AF", in about 30% of cases. The term "idiopathic AF" implies the absence of any detectable etiology including hyperthyroidism, chronic obstructive lung disease, overt sinus node dysfunction, and overt or concealed preexcitation (Wolff-Parkinson-White syndrome), only to mention a few of other uncommon causes of AF. The autonomous nervous system may contribute to the occurrence of AF in some patients. AF occurs commonly. In patients with valvular heart disease, AF is common, particularly when the mitral valve is involved. The occurrence of AF is unrelated to the severity of mitral stenosis or mitral regurgitation but is more common in patients with enlarged left atrium and congestive heart failure. In patients with coronary artery disease, AF occurs predominantly in older patients, males, and patients with left ventricular dysfunction, Important predictive factors of AF include hypertension, left ventricular hypertrophy and diabetes. The risk of the development of AF, in an individual patient, is often difficult to assess. Increasing age, presence of valvular heart disease, and congestive heart failure increase the risk of atrial fibrillation.