A proposed mechanistic classification of atrial fibrillation aims to integrate known health modifiers, such as atrial fibrosis and altered calcium homeostasis, to guide personalized management.
This consensus statement proposes a roadmap to develop clinical markers reflecting the major pathophysiological causes of atrial fibrillation to enable personalized prevention and treatment strategies.
Despite remarkable advances in antiarrhythmic drugs, ablation procedures, and stroke-prevention strategies, atrial fibrillation (AF) remains an important cause of death and disability in middle-aged and elderly individuals. Unstructured management of patients with AF sharply contrasts with our detailed, although incomplete, knowledge of the mechanisms that cause AF and its complications. Altered calcium homeostasis, atrial fibrosis and ageing, ion-channel dysfunction, autonomic imbalance, fat-cell infiltration, and oxidative stress, in addition to a susceptible genetic background, contribute to the promotion, maintenance, and progression of AF. However, clinical management of patients with AF is currently guided by stroke risk parameters, AF pattern, and symptoms. In response to this apparent disconnect between the known pathophysiology of AF and clinical management, we propose a roadmap to develop a set of clinical markers that reflect the major causes of AF in patients. Thereby, the insights into the mechanisms causing AF will be transformed into a format that can underpin future personalized strategies to prevent and treat AF, ultimately informing better patient care.
Fabritz et al. (2015) conducted a review in Atrial fibrillation. A proposed mechanistic classification of atrial fibrillation aims to integrate known health modifiers, such as atrial fibrosis and altered calcium homeostasis, to guide personalized management.