When the Clock Strikes A-fib.
| Autor: | van den Broek JLPM; Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands. Electronic address: Maarten.vd.broek@catharinaziekenhuis.nl., Gottlieb LA; University of Copenhagen, Copenhagen, Denmark., Vermeer JR; Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands., Overeem S; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands; Kempenhaeghe Centre for Sleep Medicine, Heeze, the Netherlands., Dekker LRC; Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands. |
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| Jazyk: | angličtina |
| Zdroj: | JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2024 Aug; Vol. 10 (8), pp. 1916-1928. Date of Electronic Publication: 2024 Jul 31. |
| DOI: | 10.1016/j.jacep.2024.05.035 |
| Abstrakt: | Within the broad spectrum of atrial fibrillation (AF) symptomatology, there is a striking subset of patients with predominant or even solitary nocturnal onset of the arrhythmia. This review covers AF with nocturnal onset, with the aim of defining this distinctive subgroup among patients with AF. A periodicity analysis is provided showing a clear increased onset between 10:00 pm and 7:00 am. Multiple interacting mechanisms are discussed, such as circadian modulation of electrophysiological properties, vagal tone, and sleep disorders, as well as the potential interaction and synergism between these factors, to provide a better understanding of this clinical entity. Lastly, potential therapeutic targets for AF with nocturnal onset are addressed such as upstream therapy for underlying comorbidities, type of drug and timing of drug administration and pulmonary vein isolation, ablation of the ganglionated plexus, and autonomic nervous system modulation. Understanding the underlying AF mechanisms in the individual patient with nocturnal onset will contribute to patient-specific therapy. Competing Interests: Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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