Pathophysiology of Paroxysmal and Persistent Atrial Fibrillation

Autor: Prashanthan Sanders, Rajiv Mahajan, Jonathan M. Kalman, Ulrich Schotten, Dennis H. Lau, Dominik Linz
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Pulmonary and Respiratory Medicine
Tachycardia
medicine.medical_specialty
medicine.medical_treatment
Catheter ablation
030204 cardiovascular system & hematology
STRUCTURAL HEART-DISEASE
Electrocardiography
03 medical and health sciences
0302 clinical medicine
LOCALIZED SOURCES
Heart Conduction System
Fibrosis
Internal medicine
OBSTRUCTIVE SLEEP-APNEA
MAGNETIC-RESONANCE
Medicine
Heart Atria
030212 general & internal medicine
Tachycardia
Paroxysmal
TRANSMURAL CONDUCTION
CATHETER ABLATION
medicine.diagnostic_test
business.industry
OVINE MODEL
Remodelling
Atrial fibrillation
Magnetic resonance imaging
HUMANS
Atrial Remodeling
Ectopic foci
Atrial fibrosis
medicine.disease
Mapping
Heart failure
Rotors
Cardiology
CONVENTIONAL ABLATION
Electrical conduction system of the heart
medicine.symptom
Cardiology and Cardiovascular Medicine
business
FOLLOW-UP
Zdroj: Heart Lung and Circulation. 26(9):887-893
ISSN: 1443-9506
Popis: Recent advances in our understanding of the mechanisms underlying atrial fibrillation (AF) have further underscored the complex pathophysiological basis of the arrhythmia. It has become apparent that the current clinical classification of AF does not reflect the severity of the underlying atrial disease. Atrial fibrosis has been identified as the key structural change in different substrates that are responsible for the perpetuation of AF. Three-dimensional electroanatomical mapping and late gadolinium-enhanced magnetic resonance imaging are novel modalities that can be used to facilitate identification and quantitation of atrial fibrosis for improved delineation of the AF substrate. Advances in AF mapping technology using endocardial 'panaromic' basket-type catheter and non-invasive body surface electrodes have facilitated the identification of two major arrhythmic mechanisms of interest, namely rotational ('rotors') and ectopic focal activations ('foci'). Ongoing research on these potential drivers of AF may provide guidance to more mechanistic based therapies to improve outcomes for this complex arrhythmia in the future. Here, we aim to review the differences in AF substrate in those with paroxysmal and more persistent forms of the arrhythmia by evaluating fibrosis, rotors and foci, towards improved AF substrate classification and individualised substrate based therapies.
Databáze: OpenAIRE
Externí odkaz: