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Review
. 2020 Aug;9(2):61-70.
doi: 10.15420/aer.2020.13.

Atrial Myopathy Underlying Atrial Fibrillation

Harold Rivner  1 , Raul D Mitrani  1 , Jeffrey J Goldberger  1
Affiliations
Review

Atrial Myopathy Underlying Atrial Fibrillation

Harold Rivner et al. Arrhythm Electrophysiol Rev. 2020 Aug.

Abstract

While AF most often occurs in the setting of atrial disease, current assessment and treatment of patients with AF does not focus on the extent of the atrial myopathy that serves as the substrate for this arrhythmia. Atrial myopathy, in particular atrial fibrosis, may initiate a vicious cycle in which atrial myopathy leads to AF, which in turn leads to a worsening myopathy. Various techniques, including ECG, plasma biomarkers, electroanatomical voltage mapping, echocardiography, and cardiac MRI, can help to identify and quantify aspects of the atrial myopathy. Current therapies, such as catheter ablation, do not directly address the underlying atrial myopathy. There is emerging research showing that by targeting this myopathy we can help decrease the occurrence and burden of AF.

Keywords: AF; atrial fibrosis; atrial myopathy; cardiac MRI; strain echocardiography.

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Conflict of interest statement

Disclosure: JJG and RDM receive funding from the Miami Heart Research Institute and Grant 1R01HL145165-01 from the National Heart, Lung, and Blood Institute. HR has no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Progression of Atrial Myopathy and AF
Figure 2:
Figure 2:. ECG Demonstrating P Terminal Force in V1
Figure 3:
Figure 3:. Left Atrial Voltage Map
Figure 4:
Figure 4:. Stages of Left Atrial Tissue Fibrosis on Cardiac MRI
See this image and copyright information in PMC

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