title: Atrial structure and function and its implications for current and emerging treatments for atrial fibrillation.
abstract: Left atrial (LA) structure and function are intimately related to the clinical phenotypes of atrial fibrillation (AF), and have direct implications for the success or otherwise of various therapeutic strategies. In conjunction with intrinsic structural characteristics of the LA, pathological remodelling to a large extent dictates the clinical course of AF. Remodelling is a product of the physiological and structural plasticity of the LA in disease states (including AF itself), and manifests as electrical, physical and structural changes that promote the substrate necessary for AF maintenance. The degree of remodelling impacts upon the efficacy of pharmacological, non-pharmacological and interventional treatments for AF. Evolving therapies seek to specifically target these processes although presently, several remain in the development phase. Catheter ablation (CA) is now firmly established as a highly effective treatment for AF, although increasing its efficacy in the remodelled LA of more severe AF phenotypes remains an ongoing challenge.
authors.affiliation: Department of Cardiovascular Medicine, Alfred Hospital, VIC, Australia; Baker IDI Heart and Diabetes Institute, VIC, Australia; Cardiology Department, Royal Melbourne Hospital, VIC, Australia; Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, VIC, Australia.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Prabhu
authors.affiliation: Department of Cardiovascular Medicine, Alfred Hospital, VIC, Australia; Baker IDI Heart and Diabetes Institute, VIC, Australia; Cardiology Department, Royal Melbourne Hospital, VIC, Australia; Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, VIC, Australia.
authors.forename: Alex J A
authors.initials: AJ
authors.lastname: McLellan
authors.affiliation: Department of Cardiovascular Medicine, Alfred Hospital, VIC, Australia; Cardiology Department, Royal Melbourne Hospital, VIC, Australia; Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, VIC, Australia.
authors.forename: Tomos E
authors.initials: TE
authors.lastname: Walters
authors.affiliation: Department of Cardiovascular Medicine, Alfred Hospital, VIC, Australia.
authors.forename: Meenal
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Department of Cardiovascular Medicine, Alfred Hospital, VIC, Australia.
authors.forename: Alex
authors.initials: A
authors.lastname: Voskoboinik
authors.affiliation: Department of Cardiovascular Medicine, Alfred Hospital, VIC, Australia; Baker IDI Heart and Diabetes Institute, VIC, Australia; Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, VIC, Australia. Electronic address: peter.kistler@bakeridi.edu.au.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Kistler
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D016279:Atrial Function, Left; D064752:Atrial Remodeling; D017115:Catheter Ablation; D005355:Fibrosis; D006325:Heart Atria / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D018579:Patient Selection; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors
chemical_list: D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants
keywords: Ablation; Atrial fibrillation; Atrial fibrosis; Catheter ablation; Electrical remodelling; Left atrium; Novel therapies; Structural remodelling