Prevention of atrial fibrillation.
OBJECTIVE
This review summarizes current concepts on the pathophysiology of atrial fibrillation, identifying predisposing factors to guide primary and secondary preventive approaches.


RESULTS
Many factors contribute to the development and progression of atrial fibrillation, including cardiovascular diseases, age, neurohormones, genetics, diet, autonomic influences, and inflammation. Therapeutic efforts have been directed to modify this altered milieu and prevent the development of atrial electrical and structural remodeling. This nonconventional antiarrhythmic management appears to have an important role also in secondary prevention of atrial fibrillation; the indications for conventional antiarrhythmic agents are decreasing because of side effects and limited efficacy. Interventional electrophysiology techniques have been developed to target the arrhythmia substrate responsible for the initiation or maintenance of atrial fibrillation, achieving high success rates.


CONCLUSIONS
Atrial fibrillation is the most commonly treated arrhythmia and its incidence is predicted to increase. It is associated with significant morbidity and mortality. Preventive efforts should be initiated early and include diversified interventions to correct predisposing factors and modify the altered atrial substrate.
Leonardi
Marino
M
Division of Cardiovascular Disease, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA. mleonardi@uams.edu
Bissett
Joe
J
D000375:Aging; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000379:methods; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008954:Models, Biological; D018384:Oxidative Stress; D012307:Risk Factors
D000889:Anti-Arrhythmia Agents