Atrial electrophysiological remodeling caused by rapid atrial activation: underlying mechanisms and clinical relevance to atrial fibrillation
Key result
Rapid atrial activation induces atrial remodeling, primarily via reduced L-type Ca2+ current, contributing to atrial dysfunction, therapy resistance, and progression of paroxysmal to chronic AF.
Population
Patients with atrial fibrillation and animal models of rapid atrial pacing
Design
Review
Authors
Discussion
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Implication
May warrant earlier intervention in paroxysmal AF; leaves open Ca2+-specific therapies to prevent chronicity.
Structured PICO
P
Population
Patients with atrial fibrillation and animal models of rapid atrial pacing
I
Intervention
Rapid atrial activation / atrial fibrillation
O
Outcome
Atrial electrophysiological remodeling (changes in ion channel function, specifically reduction in L-type Ca2+ current and action potential duration)
This review highlights that atrial fibrillation begets atrial fibrillation through rapid rate-induced electrophysiological remodeling, primarily driven by altered calcium channel function.
Cite This Study
Stanley Nattel (1999) conducted a review in Atrial fibrillation. Rapid atrial activation was evaluated. Rapid atrial activation induces atrial remodeling, primarily via reduced L-type Ca2+ current, contributing to atrial dysfunction, therapy resistance, and progression of paroxysmal to chronic AF.