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Clinical Articles, News & Views

Atrial fibrillation: effects beyond the atrium?

Potential mechanisms behind the effects of atrial fibrillation (AF) on the ventricular myocardium – including diffuse ventricular fibrosis, focal myocardial scarring, and impaired myocardial perfusion and perfusion reserve – are explored in a review published recently in Cardiovascular Research.1

Authors explore the complex relationship between AF, systemic inflammation, and endothelial/microvascular dysfunction, as well as the effects of AF on ventricular calcium handling and oxidative stress. Finally, consideration is given to the clinical implications of these observations and concepts, with particular reference to rate vs. rhythm control.

AF is the most common sustained clinical arrhythmia and is associated with significant morbidity, mostly secondary to heart failure and stroke, and an estimated two-fold increase in premature death. Efforts to increase our understanding of AF and its complications have focused on unravelling the mechanisms of electrical and structural remodelling of the atrial myocardium, the authors say.

Yet, it is increasingly recognised that AF is more than an atrial disease, being associated with systemic inflammation, endothelial dysfunction, and adverse effects on the structure and function of the left ventricular myocardium that may be prognostically important, they conclude.


1. Wijesurendra RS, Casadei B. Atrial fibrillation: effects beyond the atrium?  Cardiovasc Res 2015;105:238–47.

Published on: April 29, 2015

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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