Atrial fibrillation （AF） is the most frequent arrhythmia. Due to population aging, AF is a growing epidemic and its importance will continue to increase in the next decades. Although the prevalence of AF is high in ...Atrial fibrillation （AF） is the most frequent arrhythmia. Due to population aging, AF is a growing epidemic and its importance will continue to increase in the next decades. Although the prevalence of AF is high in advanced age, the number of subjects with predisposing factors for AF is even higher. Most of these factors increase the risk of atrial fibro- sis, an important component of atrial arrhythmia mecha- nisms. In fact, the new techniques to detect atrial fibrosis are showing the strong association between atrial fibrosis and AF risk. Regarding predisposing factors for AF, interatrial block （LAB） seems to be a key factor.展开更多
Atrial fibrillation （AF） is the most common arrhythmia diagnosed in clinical practice. The consequences of AF have been clearly estab- lished in multiple large observational cohort studies and include increased stro...Atrial fibrillation （AF） is the most common arrhythmia diagnosed in clinical practice. The consequences of AF have been clearly estab- lished in multiple large observational cohort studies and include increased stroke and systemic embolism rates if no oral anticoagulation is prescribed, with increased morbidity and mortality. With the worldwide aging of the population characterized by a large influx of ＂baby boomers＂ with or without risk factors for developing AF, an epidemic is forecasted within the next 10 to 20 years. Although not all studies support this evidence, it is clear that AF is on the rise and a significant amount of health resources are invested in detecting and managing AF This review focuses on the worldwide burden of AF and reviews global health strategies focused on improving detection, prevention and risk stratification of AF, recently recommended by the World Heart Federation.展开更多
Advances in clinical and fimdamental research, which have been promoted over last decades have led to a well- established understanding of atrial fibrillation （AF） as an epiphenomenon that despite similar manifestat...Advances in clinical and fimdamental research, which have been promoted over last decades have led to a well- established understanding of atrial fibrillation （AF） as an epiphenomenon that despite similar manifestations may have different underlying mechanisms and thus require in- dividualized treatments. With rare exceptions of AF caused by mutations in genes coding ion channels in pa- tients with structurally normal atria, fibrotic replacement of atrial myocardium remains the comer stone of atrial pa- thology in patients with AF.展开更多
Recent studies have suggested that patients with high CHA2DS2VASc-score [Congestive Heart failure, hyperten- sion, Age ≥ 75 years （doubled）, Diabetes, Stroke （doubled）, Vascular disease, Age 65-74 years, Sex cate...Recent studies have suggested that patients with high CHA2DS2VASc-score [Congestive Heart failure, hyperten- sion, Age ≥ 75 years （doubled）, Diabetes, Stroke （doubled）, Vascular disease, Age 65-74 years, Sex category （female sex）] thromboembolic complications occurred irrespective of the presence of atrial fibrillation （AF） and anticoagulant therapy may be initiated irrespective of documented AF.展开更多
Background Pulmonary veins （PV） and the atria undergo electrical and structural remodeling in atrial fibrillation （AF）. This study aimed to determine PV and left atrial （LA） reverse remodeling after catheter abl...Background Pulmonary veins （PV） and the atria undergo electrical and structural remodeling in atrial fibrillation （AF）. This study aimed to determine PV and left atrial （LA） reverse remodeling after catheter ablation for AF assessed by chest computed tomography （CT）. Methods PV electrophysiologic studies and catheter ablation were performed in 63 patients （68% male; mean ± SD age： 56 ± 10 years） with symptomatic AF （49% paroxysmal, 51% persistent）. Chest CT was performed before and 3 months after catheter ablation. Results At baseline, patients with persistent AF had a greater LA volume （91 ±29 cm3 vs. 66 ± 27 cm3; P = 0.003） and mean PV ostial area （241 ＋ 43 mm2 vs. 212 ± 47 mm2; P = 0.03） than patients with paroxysmal AF. There was no significant correlation between the effective refractory period and the area of the left superior PV ostium. At 3 months of follow-up after ablation, 48 patients （76%） were AF free on or off antiarrhythmic drugs. There was a significant reduction in LA volume （77 ±31 cm3 to 70 ± 28 cm3; P 〈 0.001） and mean PV ostial area （224 ± 48 mm2 to 182 ± 43 mm2; P 〈 0.001）. Patients with persistent AF had more reduction in LA volume （11.8 ± 12.8 cm3 vs. 4.0 ± 11.2 cm3; P = 0.04） and PV ostial area （62 mm2 vs. 34 mm2; P = 0.04） than those who have paroxysmal AF. The reduction of the averaged PV ostial area was significantly correlated with the reduction of LA volume （r = 0.38, P = 0.03）. Conclusions Catheter ablation of AF improves structural remodeling ofPV ostia and left atrium. This finding is more apparent in patients with persistent AF treated by catheter ablation.展开更多
文摘Atrial fibrillation （AF） is the most frequent arrhythmia. Due to population aging, AF is a growing epidemic and its importance will continue to increase in the next decades. Although the prevalence of AF is high in advanced age, the number of subjects with predisposing factors for AF is even higher. Most of these factors increase the risk of atrial fibro- sis, an important component of atrial arrhythmia mecha- nisms. In fact, the new techniques to detect atrial fibrosis are showing the strong association between atrial fibrosis and AF risk. Regarding predisposing factors for AF, interatrial block （LAB） seems to be a key factor.
文摘Atrial fibrillation （AF） is the most common arrhythmia diagnosed in clinical practice. The consequences of AF have been clearly estab- lished in multiple large observational cohort studies and include increased stroke and systemic embolism rates if no oral anticoagulation is prescribed, with increased morbidity and mortality. With the worldwide aging of the population characterized by a large influx of ＂baby boomers＂ with or without risk factors for developing AF, an epidemic is forecasted within the next 10 to 20 years. Although not all studies support this evidence, it is clear that AF is on the rise and a significant amount of health resources are invested in detecting and managing AF This review focuses on the worldwide burden of AF and reviews global health strategies focused on improving detection, prevention and risk stratification of AF, recently recommended by the World Heart Federation.
文摘Advances in clinical and fimdamental research, which have been promoted over last decades have led to a well- established understanding of atrial fibrillation （AF） as an epiphenomenon that despite similar manifestations may have different underlying mechanisms and thus require in- dividualized treatments. With rare exceptions of AF caused by mutations in genes coding ion channels in pa- tients with structurally normal atria, fibrotic replacement of atrial myocardium remains the comer stone of atrial pa- thology in patients with AF.
文摘Recent studies have suggested that patients with high CHA2DS2VASc-score [Congestive Heart failure, hyperten- sion, Age ≥ 75 years （doubled）, Diabetes, Stroke （doubled）, Vascular disease, Age 65-74 years, Sex category （female sex）] thromboembolic complications occurred irrespective of the presence of atrial fibrillation （AF） and anticoagulant therapy may be initiated irrespective of documented AF.
文摘Background Pulmonary veins （PV） and the atria undergo electrical and structural remodeling in atrial fibrillation （AF）. This study aimed to determine PV and left atrial （LA） reverse remodeling after catheter ablation for AF assessed by chest computed tomography （CT）. Methods PV electrophysiologic studies and catheter ablation were performed in 63 patients （68% male; mean ± SD age： 56 ± 10 years） with symptomatic AF （49% paroxysmal, 51% persistent）. Chest CT was performed before and 3 months after catheter ablation. Results At baseline, patients with persistent AF had a greater LA volume （91 ±29 cm3 vs. 66 ± 27 cm3; P = 0.003） and mean PV ostial area （241 ＋ 43 mm2 vs. 212 ± 47 mm2; P = 0.03） than patients with paroxysmal AF. There was no significant correlation between the effective refractory period and the area of the left superior PV ostium. At 3 months of follow-up after ablation, 48 patients （76%） were AF free on or off antiarrhythmic drugs. There was a significant reduction in LA volume （77 ±31 cm3 to 70 ± 28 cm3; P 〈 0.001） and mean PV ostial area （224 ± 48 mm2 to 182 ± 43 mm2; P 〈 0.001）. Patients with persistent AF had more reduction in LA volume （11.8 ± 12.8 cm3 vs. 4.0 ± 11.2 cm3; P = 0.04） and PV ostial area （62 mm2 vs. 34 mm2; P = 0.04） than those who have paroxysmal AF. The reduction of the averaged PV ostial area was significantly correlated with the reduction of LA volume （r = 0.38, P = 0.03）. Conclusions Catheter ablation of AF improves structural remodeling ofPV ostia and left atrium. This finding is more apparent in patients with persistent AF treated by catheter ablation.
