Update about atrial fibrillation genetics.
OBJECTIVE
Atrial fibrillation is an important cause of morbidity in the aging population. The mechanisms responsible for the triggering and maintenance of the chaotic atrial rhythm are still poorly understood. In this review, we will focus on the genetic aspects of atrial fibrillation, to understand causality, with special emphasis on recent studies published in the field.


RESULTS
Diseases such as hypertension, valvular heart disease, and heart failure may induce atrial fibrillation, which increases the risk of stroke and sudden cardiac death. Clinical studies published in these last two decades have provided evidence that genetics play a key role in atrial fibrillation. Thus, a family history of the disease has been identified in up to 30% of clinically diagnosed patients. In those genotyped families, most carry rare genetic variants in genes associated with ionic channels, calcium handling protein, or predisposing to fibrosis, conduction system disease, and inflammatory processes.


CONCLUSIONS
Currently, atrial fibrillation is the most common sustained arrhythmia in clinical practice. The pathophysiological mechanisms of atrial fibrillation are complex. A better understanding of the molecular basis will help improve both current risk stratification and clinical management.
aCardiovascular Genetics Center, University of Girona - IDIBGI bCentro Investigación Biomédica en Red. Enfermedades Cardiovasculares (CIBERCV) cDepartment of Medical Sciences, School of Medicine, University of Girona dCardiomyopathies Unit, Hospital Josep Trueta, Girona, Spain.
Alexandra
A
Pérez-Serra
Oscar
O
Campuzano
Ramon
R
Brugada