Vol 15, No 5 (2020)
Review paper
Published online: 2020-12-30
Pathophysiology of atrial fibrillation. Systemic review
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DOI: 10.5603/FC.2020.0050
Folia Cardiologica 2020;15(5):349-354.
Abstract
Abstract Atrial fibrillation (AF) is an arrhythmia in which chaotic electrical signals are generated in the atria. AF can be classified as: first episode AF, paroxysmal AF, persistent AF, long-standing persistent AF and permanent AF. Hence, AF is one of the biggest problems of the contemporary health care (due to severe complications like thromboembolic disease and huge expenses which associated with the treatment). The pathophysiology of the AF includes a triggered activity in the myocardium, and also left atrial enlargement (LAE), and remodeling of the atria that may result in interatrial block (IAB). IAB is a prolonged conduction between the atria, and is diagnosed in ECG, when P-wave duration ≥ 110 ms. Other ECG changes coexisting with IAB, LAE and also remodeling of the atria are attributed to P wave dispersion ≥ 40 ms, and a P wave terminal force in V1 ≤ ‑0.04 mm/sec. Remodeling of the atria leads to structural, cellular and hormonal changes. At the cellular scale – mitochondrial size and count are enlarged. Neurohormonal imbalance is also related to arrhythmia. An increased level of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), angiotensin II, transforming growth factor-β1 (TGF-β1) are observed in the case of cellular and ion channels changes. Atrial fibrillation is a significant problem posed to modern health care. In light of these remarks, an effective way of AF prevention needs to be found. In any case, further research in this field is needed.
Keywords: atrial fibrillationinteratrial blockelectrocardiography.
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