Key result
Atrial fibrosis is associated with the persistency of atrial fibrillation, though its mechanistic role may differ based on the presence of underlying structural heart disease.
Atrial fibrosis is a key component in the mechanisms of atrial fibrillation, though its role may differ between lone AF and AF with advanced comorbidities.
Hypothesis-generating on atrial fibrosis causality in AF; leaves open whether remodeling precedes or follows arrhythmia onset.
Atrial fibrosis is common in atrial fibrillation (AF). Experimental studies have provided convincing evidence that fibrotic transformation of atrial myocardium results in deterioration of atrial conduction, increasing anisotropy of impulse propagation and building of boundaries that promote re-entry in the atrial walls that maybe directly relevant for the mechanisms responsible for maintaining AF. Whether or not fibrosis is a result of structural remodelling caused by persistent AF or a manifestation of occult myocardial process that leads to development of arrhythmia is less clear. Human data indicate the presence of association between persistency of AF and the extent of structural changes in atrial myocardium. The role atrial fibrosis plays in the mechanisms of AF, however, may differ between patients with structurally normal hearts, such as lone AF, and those with advanced cardiovascular comorbidities.
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Pyotr G. Platonov (2017) conducted a review in Atrial fibrillation. Atrial fibrosis was evaluated. Atrial fibrosis is associated with the persistency of atrial fibrillation, though its mechanistic role may differ based on the presence of underlying structural heart disease.
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