title: Biophysical aspects and novel treatments of atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) is a cardiac arrhythmia caused by various mechanisms, such as multiple re-entering wavelets, high frequency activity, and rotor sources.
  
  
  METHODS
  This narrative review was based on papers found on PubMed and MEDLINE up to May 2016. The search terms were "atrial fibrillation" in combination with "catheter ablation, pathophysiology, antiarrhythmic drugs".
  
  
  RESULTS
  Antiarrhythmic drugs are the cornerstone of therapy in AF, but their efficacy and safety might have to be improved. In case of failure of pharmacologic therapies, other treatments can be considered. A better understanding of the important role of the pulmonary veins has led to new approaches, such as ablation procedures, which were initially only surgical, while percutaneous options were later added. However, these strategies may present various technical complications also when performed by skilled operators. A promising field of investigation is the genetics of AF, as highlighted by studies on the role of micro-RNA.
  
  
  CONCLUSIONS
  Relevant improvement on the knowledge of the electrophysiological basis of genesis and maintenance of AF has been done in order to treat a very common arrhythmia, but further studies, as those in the genetics field, can open new challenging therapeutic horizons.
authors.affiliation: Department of Cardiology, IRCCS S. Martino Hospital, University of Genoa, Genoa, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Gigli
authors.affiliation: Department of Cardiology, IRCCS S. Martino Hospital, University of Genoa, Genoa, Italy.
authors.forename: Gian M
authors.initials: GM
authors.lastname: Rosa
authors.affiliation: Department of Cardiology, IRCCS S. Martino Hospital, University of Genoa, Genoa, Italy.
authors.forename: Maria I
authors.initials: MI
authors.lastname: Tagliasacchi
authors.affiliation: Department of Internal Medicine, First Clinic of Internal Medicine, University of Genoa, Genoa, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Bonaventura
authors.affiliation: Department of Internal Medicine, First Clinic of Internal Medicine, University of Genoa, Genoa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Liberale
authors.affiliation: Department of Internal Medicine, First Clinic of Internal Medicine, University of Genoa, Genoa, Italy - fabrizio.montecucco@unige.it.|IRCCS AOU San Martino-IST, Genoa, Italy.|Centre of Excellence for Biomedical Research (CEBR), University of Genoa, Genoa, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Montecucco
authors.affiliation: Department of Internal Medicine, First Clinic of Internal Medicine, University of Genoa, Genoa, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Carbone
authors.affiliation: Department of Cardiology, IRCCS S. Martino Hospital, University of Genoa, Genoa, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bertero
authors.affiliation: Department of Cardiology, IRCCS S. Martino Hospital, University of Genoa, Genoa, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Brunelli
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy*; D001703:Biophysics; D017115:Catheter Ablation; D055724:Electrophysiological Phenomena; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents