title: Inflammation and the pathogenesis of atrial fibrillation.
abstract: Atrial fibrillation (AF) is the most common cardiac arrhythmia. However, the development of preventative therapies for AF has been disappointing. The infiltration of immune cells and proteins that mediate the inflammatory response in cardiac tissue and circulatory processes is associated with AF. Furthermore, the presence of inflammation in the heart or systemic circulation can predict the onset of AF and recurrence in the general population, as well as in patients after cardiac surgery, cardioversion, and catheter ablation. Mediators of the inflammatory response can alter atrial electrophysiology and structural substrates, thereby leading to increased vulnerability to AF. Inflammation also modulates calcium homeostasis and connexins, which are associated with triggers of AF and heterogeneous atrial conduction. Myolysis, cardiomyocyte apoptosis, and the activation of fibrotic pathways via fibroblasts, transforming growth factor-β and matrix metalloproteases are also mediated by inflammatory pathways, which can all contribute to structural remodelling of the atria. The development of thromboembolism, a detrimental complication of AF, is also associated with inflammatory activity. Understanding the complex pathophysiological processes and dynamic changes of AF-associated inflammation might help to identify specific anti-inflammatory strategies for the prevention of AF.
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, National Yang-Ming University, Number 201, Section 2, Shipai Road, Beitou District, Taipei 11217, Taiwan, Republic of China.
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Hu
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Number 111, Section 3, Hsing-Long Road, Taipei 11696, Taiwan, Republic of China.
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Chen
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, National Yang-Ming University, Number 201, Section 2, Shipai Road, Beitou District, Taipei 11217, Taiwan, Republic of China.
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, National Yang-Ming University, Number 201, Section 2, Shipai Road, Beitou District, Taipei 11217, Taiwan, Republic of China.
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D015551:Autoimmunity; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D017115:Catheter Ablation / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000150:complications; D016207:Cytokines / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000150:complications; D007249:Inflammation / Q000150:complications*; D018836:Inflammation Mediators / Q000097:blood; D009765:Obesity / Q000150:complications; D020257:Ventricular Remodeling / Q000502:physiology
chemical_list: D000893:Anti-Inflammatory Agents; D016207:Cytokines; D018836:Inflammation Mediators