Electrophysiological characteristics of permanent atrial fibrillation: insights from research models of cardiac remodeling

Abstract

However, the lack of appropriate research models of remodelled atrial tissue precludes the elucidation of the underlying AF mechanisms and the identification of appropriated therapeutic targets. Here, we summarize the different research models used to date, highlighting the lessons learned from them and pointing to the new doors that should be open for the development of innovative treatments for AF.

Balance between sodium and calcium currents underlying chronic atrial fibrillation termination: An in silico intersubject variability study

“…One of the explanations for this lack of success in chronic AF patients is the remodeling process of atrial tissue. Prolonged periods of AF result in changes in the characteristics of AF drivers (e.g., dominant frequency [DF], rotor meandering, wavefront curvature) and promote AF maintenance 3 . Understanding the ionic mechanisms that govern AF drivers will allow the development of more effective antiarrhythmic drug treatments in remodeled substrates.…”

“…Another potential strategy, based on most recent knowledge about perpetuation of AF by rotors, is to focus on destabilizing rotor cores. An increase in rotor core movement may promote its extinction by collision with other wavefronts or anatomic obstacles 3 and thus appears to be an attractive target for antiarrhythmic drugs. Therefore, an in-depth understanding of the ionic mechanisms that govern self-sustained reentries under remodeled conditions is needed.…”

Isolation of pulmonary veins using a thermoreactive implantable device with external energy transfer: Evaluation in a porcine model

“…This could be completed in one procedure, however, as each ablation session is short. Although the ablation itself is not invasive, positioning of multiple devices is. Nevertheless, shorter procedure times are possible than for current techniques. This technique may not be sufficient for patients with persistent or long‐standing persistent AF, since the underlying mechanism of AF may not be confined to the PVs Although all seven chronic animals were in apparent good health before sacrifice, we did not actively investigate the possibility of phrenic nerve injury. AF ablation is not limited to PVI but this poses a limitation for this technology as no additional ablation lines can be applied with this technique. In our study, we cannot conclude whether the stent implantation or ablation procedure was associated with thrombus formation.…”

“…This technique may not be sufficient for patients with persistent or long‐standing persistent AF, since the underlying mechanism of AF may not be confined to the PVs …”

The Effects of CYP2C19 genotype on the susceptibility for nephrosis in cardio-cerebral vascular disease treated by anticoagulation

“…In order to achieve the purpose of diagnosis and treatment, variety of drugs were used to patient body in the era of modern medicine. [ 21 ] Unfortunately, some of these drugs lead to adverse side effect and systemic toxicity, including impaired renal function. Many classes of drugs, including prescription drug and blame prescription drug, caused drug-induced renal impairment.…”