Atrial Fibrillation - Article Example

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885, define atrial fibrillation (AF) as” a supraventricular tachyarrhythmia characterized by uncoordinated atrial activation”. The most common trigger for AF is ectopic foci in the atria that get perpetuated through micro re-entrant circuits…
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Atrial Fibrillation
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Download file to see previous pages Possible causes that give rise to AF include comorbidities like hypertension, coronary ischemia, heart failure and obstructive sleep apnoea.
The characteristic features of electrical remodelling are alterations in atrial refractoriness, atrial conduction and sinus node function. This happens very quickly and is considered possible to reverse. Loss of contractility results from the contractile remodelling that happens in AF and like electrical remodelling happens very quickly. Reduction in the release of systolic calcium ions is believed to contribute to this change. Myolysis or the loss of sarcomeres is also a likely candidate for this change. The consequences of contractile remodelling are thrombus formation and atrial dilation. Advance of AF may be caused by contractile remodelling through the coexistence of multiple wavelets. Reversing contractility changes takes longer than in the case of reversing electrical remodelling changes possible because of the time involved in the replacement of lost sarcomeres. Persistent AF has been associated with the structural changes within the atria. Many of these changes are considered to be irreversible. Evidence from animal studies suggests that these changes occur more slowly than the changes that occur from electrical and contractile remodelling and primarily reflect dedifferentiation. The striking changes seen in animal models are increased cell size, myolysis, and the collection of glycogen around the nucleus of the cell. From the limited data from humans there is indication that degenerative changes may occur (Cohen & Naccarelli, 2008).
Management of AF is a three pronged strategy. The first is of the prongs is anticoagulation. Use of anticoagulation is guided by the CHAD scoring system set forth by the American College of Cardiology, American Heart Association, and the European Society of cardiology.
When the AF patient has any one of these ...Download file to see next pagesRead More
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