Life (May 2023)

Mechanisms of Atrial Fibrillation: How Our Knowledge Affects Clinical Practice

  • Georgios Leventopoulos,
  • Rafail Koros,
  • Christoforos Travlos,
  • Angelos Perperis,
  • Panagiotis Chronopoulos,
  • Evropi Tsoni,
  • Eleni-Evangelia Koufou,
  • Athanasios Papageorgiou,
  • Anastasios Apostolos,
  • Panagiotis Kaouris,
  • Periklis Davlouros,
  • Grigorios Tsigkas

DOI
https://doi.org/10.3390/life13061260
Journal volume & issue
Vol. 13, no. 6
p. 1260

Abstract

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Atrial fibrillation (AF) is a very common arrhythmia that mainly affects older individuals. The mechanism of atrial fibrillation is complex and is related to the pathogenesis of trigger activation and the perpetuation of arrhythmia. The pulmonary veins in the left atrium arei confirm that onfirm the most common triggers due to their distinct anatomical and electrophysiological properties. As a result, their electrical isolation by ablation is the cornerstone of invasive AF treatment. Multiple factors and comorbidities affect the atrial tissue and lead to myocardial stretch. Several neurohormonal and structural changes occur, leading to inflammation and oxidative stress and, consequently, a fibrotic substrate created by myofibroblasts, which encourages AF perpetuation. Several mechanisms are implemented into daily clinical practice in both interventions in and the medical treatment of atrial fibrillation.

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