TY - JOUR
T1 - A proposal for new clinical concepts in the management of atrial fibrillation
AU - Camm, A John
AU - Al-Khatib, Sana M
AU - Calkins, Hugh
AU - Halperin, Jonathan L
AU - Kirchhof, Paulus
AU - Lip, Gregory Y H
AU - Nattel, Stanley
AU - Ruskin, Jeremy
AU - Banerjee, Amitava
AU - Blendea, Dan
AU - Guasch, Eduard
AU - Needleman, Matthew
AU - Savelieva, Irina
AU - Viles-Gonzalez, Juan
AU - Williams, Eric S
N1 - Copyright © 2012 Mosby, Inc. All rights reserved.
PY - 2012/9
Y1 - 2012/9
N2 - Atrial fibrillation (AF) represents a growing public health burden. It is a complex condition, involving a number of etiologic factors and arrhythmia mechanisms associated with atrial remodeling. Greater understanding of these mechanisms may improve therapy. Current AF classification schemes are limited by simplicity. A number of risk factors predict AF onset, and additional factors are being evaluated in registry studies. Doppler imaging and Holter monitoring in high-risk patients to predict the onset of AF and progression from paroxysmal to permanent AF are promising. There is a need for a novel multifactorial classification model encompassing AF duration, symptoms, markers of atrial remodeling, and a risk score for AF onset, persistence, progression, and complications to guide treatment and prognostication. Preventing AF onset with upstream therapy is of great interest, but current data are conflicting. More study is needed to optimize rhythm control with antiarrhythmic drugs and targeted ablation to specific patient populations at an earlier stage. There is little consensus on optimal rate control and no information relating to optimum rate control in specific populations. This article highlights new concepts in AF and directions for future research.
AB - Atrial fibrillation (AF) represents a growing public health burden. It is a complex condition, involving a number of etiologic factors and arrhythmia mechanisms associated with atrial remodeling. Greater understanding of these mechanisms may improve therapy. Current AF classification schemes are limited by simplicity. A number of risk factors predict AF onset, and additional factors are being evaluated in registry studies. Doppler imaging and Holter monitoring in high-risk patients to predict the onset of AF and progression from paroxysmal to permanent AF are promising. There is a need for a novel multifactorial classification model encompassing AF duration, symptoms, markers of atrial remodeling, and a risk score for AF onset, persistence, progression, and complications to guide treatment and prognostication. Preventing AF onset with upstream therapy is of great interest, but current data are conflicting. More study is needed to optimize rhythm control with antiarrhythmic drugs and targeted ablation to specific patient populations at an earlier stage. There is little consensus on optimal rate control and no information relating to optimum rate control in specific populations. This article highlights new concepts in AF and directions for future research.
KW - Atrial Fibrillation
KW - Humans
U2 - 10.1016/j.ahj.2012.05.017
DO - 10.1016/j.ahj.2012.05.017
M3 - Article
C2 - 22980294
SN - 0002-8703
VL - 164
SP - 292-302.e1
JO - American Heart Journal
JF - American Heart Journal
IS - 3
ER -