Atrial fibrillaton

Atrial fibrillation is the most common supraventricular arrhythmia affecting an increasing proportion of the population in which mainstream therapy, i.e. catheter ablation, provides freedom from arrhythmia in only a limited number of patients. Understanding the mechanism is key in order to find more effective therapies and to improve patient selection. In this review, the structural and electrophysiological changes of the atrial musculature that constitute atrial remodeling in atrial fibrillaton and how risk factors and markers of disease progression can predict catheter ablation outcome will be discussed in detail...

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Left atrial catheter ablation (LACA) has become an established therapy to abolish drug-refractory symptomatic paroxysmal and persistent atrial fibrillation. Restoring sinus rhythm by LACA may help to prevent atrial fibrillation-related strokes, but presently there is no evidence from randomized clinical trials to support this notion. This review summarizes the current knowledge and uncertainties regarding LACA and procedure-related ischemic stroke. In fact, most patients who undergo LACA have a rather low annual stroke risk even when left untreated, whereas LACA imposes a risk of procedure-related stroke of ≈0...

Mild gender-specific differences in myocellular and invasive electrophysiology have been described recently. Importantly, the QT interval is slightly prolonged in women, when compared to men. In men atrial fibrillaton, preexcitation and ventricular tachycardia are found more often. Modifications of the cellular "milieu" come from hormonal factors and the autonomous nervous system. The interaction of theses influences with regional cellular factors will help us in the future to analyze gender-specific factors of arrhythmogenesis and develop treatment and prevention strategies...