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Mechanisms of Atrial Arrhythmias pp 201–225Cite as

Atrial Fibrillation

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Abstract

Atrial fibrillation is the most common persistent cardiac arrhythmia [1]. Rates of hospitalisation and the cost of treatment of AF are increasing in epidemic proportions [2, 3]. AF can predispose to stroke, ventricular fibrillation, heart attack and in some cases lead to sudden cardiac death [1, 4]. Despite this, the mechanisms underlying the development and sustenance of AF are incompletely understood [5], although the large degree of electrical heterogeneity and structural anisotropy are thought to be important [6–12]. Further to this, current treatment of AF is relatively poor [5]. Many drug therapies have adverse side effects in the ventricles. IKur is an ion channel of interest as a potential target for drug therapies because it is not expressed in the ventricles. The role which electrical remodelling associated with AF plays in the genesis and sustenance of AF is also incompletely understood. Hence, the aims of this Chapter are to (1) provide insight into the underlying mechanisms of AF; (2) analyse the most vulnerable regions of the atria to the development of AF (3) quantify the effect of AF-induced remodelling in the behaviour of AF and (4) to investigate the possibility of IKur as a potential target for drug therapies.

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References

  1. Nattel S, Shiroshita-Takeshita A, Brundel BJJM, Rivard L (2005) Mechanisms of atrial fibrillation: lessons from animal models. Prog Cardiovasc Dis 48(1):9–28

    Article  Google Scholar 

  2. Anter E, Jessup M, Callans DJ (2009) Atrial fibrillation and heart failure: treatment considerations for a dual epidemic. Circulation 119(18):2516–2525

    Article  Google Scholar 

  3. Stewart S, Murphy NF, Murphy N, Walker A, McGuire A, McMurray JJV (2004) Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK. Heart 90(3):286–292

    Article  Google Scholar 

  4. Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D (1998) Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation 98(10):946–952

    Article  Google Scholar 

  5. Ehrlich JR, Nattel S (2009) Novel approaches for pharmacological management of atrial fibrillation. Drugs 69(7):757–774

    Article  Google Scholar 

  6. Moe GK, Rheinboldt WC, Abildskov JA (1964) A Computer Model of Atrial Fibrillation. Am Heart J 67:200–220

    Article  Google Scholar 

  7. Sato S, Yamauchi S, Schuessler RB, Boineau JP, Matsunaga Y, Cox JL (1992) The effect of augmented atrial hypothermia on atrial refractory period, conduction, and atrial flutter/fibrillation in the canine heart. J Thorac Cardiovasc Surg 104(2):297–306

    Google Scholar 

  8. Wang Z, Feng J, Nattel S (1995) Idiopathic atrial fibrillation in dogs: electrophysiologic determinants and mechanisms of antiarrhythmic action of flecainide. J Am Coll Cardiol 26(1):277–286

    Article  Google Scholar 

  9. Wang J, Liu L, Feng J, Nattel S (1996) Regional and functional factors determining induction and maintenance of atrial fibrillation in dogs. Am J Physiol 271(1 Pt 2):H148–H158

    Google Scholar 

  10. Liu L, Nattel S (1997) Differing sympathetic and vagal effects on atrial fibrillation in dogs: role of refractoriness heterogeneity. Am J Physiol 273(2 Pt 2):H805–H816

    Google Scholar 

  11. Gaspo R, Bosch RF, Talajic M, Nattel S (1997) Functional mechanisms underlying tachycardia-induced sustained atrial fibrillation in a chronic dog model. Circulation 96(11):4027–4035

    Article  Google Scholar 

  12. Boutjdir M, Le Heuzey JY, Lavergne T, Chauvaud S, Guize L, Carpentier A, et al (1986) Inhomogeneity of cellular refractoriness in human atrium: factor of arrhythmia? Pacing Clin Electrophysiol 9(6 Pt 2):1095–1100

    Google Scholar 

  13. Aslanidi OV, Boyett MR, Dobrzynski H, Li J, Zhang H (2009) Mechanisms of transition from normal to reentrant electrical activity in a model of rabbit atrial tissue: interaction of tissue heterogeneity and anisotropy. Biophys J 96(3):798–817

    Article  Google Scholar 

  14. Bikou O, Thomas D, Trappe K, Lugenbiel P, Kelemen K, Koch M et al (2011) Connexin 43 gene therapy prevents persistent atrial fibrillation in a porcine model. Cardiovasc Res 92(2):218–225

    Article  Google Scholar 

  15. Severs NJ, Bruce AF, Dupont E, Rothery S (2008) Remodelling of gap junctions and connexin expression in diseased myocardium. Cardiovasc Res 80(1):9–19

    Article  Google Scholar 

  16. Severs NJ, Coppen SR, Dupont E, Yeh H-I, Ko Y-S, Matsushita T (2004) Gap junction alterations in human cardiac disease. Cardiovasc Res 62(2):368–377

    Article  Google Scholar 

  17. Van der Velden HMW, Jongsma HJ (2002) Cardiac gap junctions and connexins: their role in atrial fibrillation and potential as therapeutic targets. Cardiovasc Res 54(2):270–279

    Article  Google Scholar 

  18. Polontchouk L, Haefliger JA, Ebelt B, Schaefer T, Stuhlmann D, Mehlhorn U et al (2001) Effects of chronic atrial fibrillation on gap junction distribution in human and rat atria. J Am Coll Cardiol 38(3):883–891

    Article  Google Scholar 

  19. Sanders P, Berenfeld O, Hocini M, Jaïs P, Vaidyanathan R, Hsu L-F et al (2005) Spectral analysis identifies sites of high-frequency activity maintaining atrial fibrillation in humans. Circulation 112(6):789–797

    Article  Google Scholar 

  20. Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al (2006) Guidelines for the management of patients with atrial fibrillation. Executive summary. Rev Esp Cardiol 59(12):1329

    Google Scholar 

  21. Aslanidi OV, Colman MA, Zhao J, Smaill BH, Gilbert SH, Hancox JC, et al. (2012) Arrhythmogenic substrate for atrial fibrillation: Insights from an integrative computational model of pulmonary veins. Annu Int Conf IEEE Eng Med Biol Soc EMBC 2012:203–206

    Google Scholar 

  22. Butters T, Zhao J, Smaill B, Zhang H (2012) The role of tissue heterogeneity and anisotropy in the genesis and development of atrial fibrillation. Proc Physiol Soc 28, C19 and PC19

    Google Scholar 

  23. Aslanidi OV, Colman MA, Stott J, Dobrzynski H, Boyett MR, Holden AV et al (2011) 3D virtual human atria: a computational platform for studying clinical atrial fibrillation. Prog Biophys Mol Biol 107(1):156–168

    Article  Google Scholar 

  24. Ridler M, McQueen DM, Peskin CS, Vigmond E (2006) Action potential duration gradient protects the right atrium from fibrillating. Conf Proc IEEE Eng Med Biol Soc 1:3978–3981

    Google Scholar 

  25. Kharche S, Zhang H (2008) Simulating the effects of atrial fibrillation induced electrical remodeling: a comprehensive simulation study. Conf Proc IEEE Eng Med Biol Soc 2008:593–596

    Google Scholar 

  26. Kharche S, Adeniran I, Stott J, Law P, Boyett MR, Hancox JC et al (2012) Pro-arrhythmogenic effects of the S140G KCNQ1 mutation in human atrial fibrillation—insights from modelling. J Physiol (Lond) 590(Pt 18):4501–4514

    Article  Google Scholar 

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Authors and Affiliations

  1. School of Physics and Astronomy, University of Manchester, Oxford Road, Manchester, M13 9PL, UK

    Michael A. Colman

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  1. Michael A. Colman
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Correspondence to Michael A. Colman .

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© 2014 Springer International Publishing Switzerland

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Colman, M.A. (2014). Atrial Fibrillation. In: Mechanisms of Atrial Arrhythmias. Springer Theses. Springer, Cham. https://doi.org/10.1007/978-3-319-01643-6_8

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