Atrial fibrillation: from atrial extrasystoles to atrial cardiomyopathy – what have we learned from basic science and interventional procedures?

Blomström‐Lundqvist, Carina

doi:10.1111/joim.12477

Cited by 2 publications

(2 citation statements)

References 10 publications

(6 reference statements)

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“…While some components of these changes to the LA are reversible (or adaptive), others such as progressive fibrosis are more permanent, or maladaptive (77). Currently, there is a lack of standard techniques to preoperatively assess the degree of atrial fibrosis and to identify the potential rotors for AF, which could theoretically improve the results of catheter ablation, especially in patients with longstanding and persistent AF (78). Regarding mapping and AC, there has been significant progress in developing multi-modality inputs into standard electroanatomic mapping techniques to achieve a greater understanding of arrhythmic substrate.…”

Section: Ac In Electrophysiology Studies and Ep Interventionsmentioning

confidence: 99%

“…There are no reliable serum biomarkers that predict both the burden of atrial fibrosis and also the recurrence of AF after ablation (78). Thus, insights into the AC substrate with cardiac imaging and catheter-based approaches allow for optimal prognostication and treatment of AF and other supraventricular arrhythmias.…”

Section: Ac In Electrophysiology Studies and Ep Interventionsmentioning

confidence: 99%

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Atrial Cardiomyopathy: An Unexplored Limb of Virchow's Triad for AF Stroke Prophylaxis

Darlington

McCauley

2020

Front. Cardiovasc. Med.

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The most dreaded complication of atrial fibrillation is stroke, and 70-80% of patients with AF-related stroke die or become disabled. The mechanisms of thromboembolism in AF are multifactorial, with evidence demonstrating that all three criteria of Virchow's triad are satisfied in AF: abnormal stasis of blood, endothelial damage, and hypercoagulability. Mechanistic insights into the latter two limbs have resulted in effective stroke prophylactic therapies (left atrial appendage occlusion and oral anticoagulants); however, despite these advances, there remains an excess of stroke in the AF population that may be due, in part, to a lack of mechanistic understanding of atrial hypocontractility resulting in abnormal stasis of blood within the atrium. These observations support the emerging concept of atrial cardiomyopathy as a cause of stroke. In this Review, we evaluate molecular, translational, and clinical evidence for atrial cardiomyopathy as a cause for stroke from AF, and present a rationale for further investigation of this largely unaddressed limb of Virchow's triad in AF.

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Section: Ac In Electrophysiology Studies and Ep Interventionsmentioning

confidence: 99%

Section: Ac In Electrophysiology Studies and Ep Interventionsmentioning

confidence: 99%