[Atrial fibrillation - Links between principles of pathophysiology and treatment]

Abstract

Atrial fibrillation is the most common supraventricular arrhythmia in humans, basic and clinical sciences are still developing. This present review aims to inform non-cardiologists respectively non-electrophysiologists about the most important pathophysiological concepts and their influence on therapeutical principles of atrial fibrillation. Moe's and Allessie's "multiple wavelet" theory is introduced as well as Haissaguerre's concept of ectopic triggering of paroxysmal atrial fibrillation and the most important aspects of atrial remodeling ("atrial fibrillation begets atrial fibrillation" according to Wijffels) during persistence of atrial fibrillation. Impact of these pathophysiological concepts is discussed within the context of medicamentous, surgical and interventional therapy. Concomitantly, limitations of these therapies due to pathophysiological considerations are delineated.