Atrial Fibrillation: The Science behind Its Defiance
| Autor: | Maureen E. Czick, David I. Silverman, Christine L. Shapter |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
autonomic imbalance medicine.medical_treatment Catheter ablation surgical maze procedure Review Article 030204 cardiovascular system & hematology Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Limbic system antiarrhythmic drugs Internal medicine catheter ablation Medicine atrial fibrillation 030212 general & internal medicine pathophysiology Fibrillation Modalities business.industry Atrial fibrillation Cell Biology Reentry medicine.disease medicine.anatomical_structure Renal sympathetic denervation Surgical Maze Procedure Cardiology cardiovascular system Neurology (clinical) Geriatrics and Gerontology medicine.symptom business |
| Zdroj: | Aging and Disease |
| ISSN: | 2152-5250 |
| Popis: | Atrial fibrillation (AF) is the most prevalent arrhythmia in the world, due both to its tenacious treatment resistance, and to the tremendous number of risk factors that set the stage for the atria to fibrillate. Cardiopulmonary, behavioral, and psychological risk factors generate electrical and structural alterations of the atria that promote reentry and wavebreak. These culminate in fibrillation once atrial ectopic beats set the arrhythmia process in motion. There is growing evidence that chronic stress can physically alter the emotion centers of the limbic system, changing their input to the hypothalamic-limbic-autonomic network that regulates autonomic outflow. This leads to imbalance of the parasympathetic and sympathetic nervous systems, most often in favor of sympathetic overactivation. Autonomic imbalance acts as a driving force behind the atrial ectopy and reentry that promote AF. Careful study of AF pathophysiology can illuminate the means that enable AF to elude both pharmacological control and surgical cure, by revealing ways in which antiarrhythmic drugs and surgical and ablation procedures may paradoxically promote fibrillation. Understanding AF pathophysiology can also help clarify the mechanisms by which emerging modalities aiming to correct autonomic imbalance, such as renal sympathetic denervation, may offer potential to better control this arrhythmia. Finally, growing evidence supports lifestyle modification approaches as adjuncts to improve AF control. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|