Mechanisms Underlying AF: Triggers, Rotors, Other?

Current Treatment Options in Cardiovascular Medicine
David E KrummenAmir A Schricker

Abstract

There is ongoing debate regarding the precise mechanisms underlying atrial fibrillation (AF). An improved understanding of these mechanisms is urgently needed to improve interventional strategies to suppress and eliminate AF, since the success of current strategies is suboptimal. At present, guidelines for AF ablation focus on pulmonary vein (PV) isolation for the prevention of arrhythmia. Additional targets are presently unclear, and include additional linear ablation and electrogram-guided substrate modification, without clear mechanistic relevance. PV and non-PV triggers are likely central in the first few seconds of AF initiation. Rapid activation from such triggers interacts with transitional mechanisms including conduction velocity slowing, action potential duration (APD) alternans, and steep APD restitution to cause conduction block and initiate functional reentry. However, complete suppression of potential triggers has proven elusive, and the intra-procedural mapping and targeting of transitional mechanisms has not been reported. A growing body of research implicates electrical rotors and focal sources as central mechanisms for the maintenance of AF. In several recent series, they were observed in nearly all patients wi...Continue Reading

References

Sep 1, 1977·Annals of Internal Medicine·M E Josephson, J A Kastor
Nov 1, 1990·Proceedings of the National Academy of Sciences of the United States of America·J M DavidenkoJ Jalife
Oct 1, 1983·American Heart Journal·D P ZipesE N Prystowsky
Nov 17, 1995·Science·R A GrayA M Pertsov
Feb 1, 1996·Pacing and Clinical Electrophysiology : PACE·M A WoodK A Ellenbogen
Sep 3, 1998·The New England Journal of Medicine·M HaïssaguerreJ Clémenty
May 17, 2000·Proceedings of the National Academy of Sciences of the United States of America·A GarfinkelP S Chen
Jun 14, 2002·Cardiovascular Research·James KnellerStanley Nattel
Jun 26, 2003·Pacing and Clinical Electrophysiology : PACE·Gjin NdrepepaClaus Schmitt
Jun 26, 2003·Pacing and Clinical Electrophysiology : PACE·Bengt HerwegJonathan S Steinberg
Feb 1, 1964·American Heart Journal·G K MOEJ A ABILDSKOV
Jun 3, 2004·Journal of the American College of Cardiology·Koonlawee NademaneeTachapong Ngarmukos
Sep 1, 2005·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Benjamin J ScherlagRalph Lazzara
Oct 29, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Hakan OralFred Morady
Nov 24, 2005·Journal of Cardiovascular Electrophysiology·Michel HaïssaguerrePierre Jaïs
Jan 31, 2006·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Sunny S PoWarren M Jackman
Mar 21, 2006·Journal of the American College of Cardiology·Eugene PattersonSunny S Po
May 27, 2006·Circulation Research·James N WeissZhilin Qu
Aug 2, 2006·Circulation·Martyn P NashPeter Taggart
Nov 1, 2006·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Peng-Sheng Chen
Jan 19, 2007·Journal of Cardiovascular Electrophysiology·Thomas ArentzMichel Haïssaguerre
Sep 4, 2007·Journal of Cardiovascular Electrophysiology·Shih-Lin ChangShih-Ann Chen
Dec 11, 2007·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Elizabeth M CherryFlavio H Fenton
Dec 17, 2008·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Claude S ElayiAndrea Natale

❮ Previous
Next ❯

Citations

May 28, 2017·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Emilie GregersMorten S Olesen
Jul 25, 2017·Advances in Therapy·Nebojša MujovićTatjana S Potpara
May 14, 2018·Journal of Molecular Medicine : Official Organ of the Gesellschaft Deutscher Naturforscher Und Ärzte·Alexander T Mikhailov, Mario Torrado
Apr 17, 2020·Frontiers in Cardiovascular Medicine·Pim R R van GorpAntoine A F de Vries

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Related Papers

Circulation Journal : Official Journal of the Japanese Circulation Society
Gautam G LalaniSanjiv M Narayan
Journal of Thoracic Disease
David E KrummenSanjiv M Narayan
Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
Tina BaykanerSanjiv M Narayan
Current Cardiology Reports
Amir A SchrickerSanjiv M Narayan
© 2021 Meta ULC. All rights reserved