The Pathophysiology of Atrial Fibrillation

  • John Rawles


Histological examination of the heart of a patient who has had chronic atrial fibrillation invariably shows abnormalities of the atria, the sinus node, and the region where they are contiguous (James 1982; Ih and Saitoh 1982). Patchy, focal degeneration and fibrosis of atrial myocardium and the conducting system are characteristic, and predispose to atrial fibrillation by virtue of the resulting inhomogeneity of refractoriness and repolarisation. Focal changes in the atria may result directly from involvement by inflammatory conditions such as rheumatic fever or sarcoidosis, or indirectly by occlusion of small arteries supplying the atria. The atrial myocardium may be patchily infiltrated with amyloid or tumour, or show reactive fibrosis as in haemachromatosis (Hodkinson and Pomerance 1977). Idiopathic focal degeneration of the atria, which may be very extensive, may also be seen, sometimes in several family members (Amat-Y-Leon et al. 1974; Waters et al. 1975).


Atrial Fibrillation Refractory Period Paroxysmal Atrial Fibrillation Accessory Pathway Ventricular Rate 
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Copyright information

© Springer-Verlag London Limited 1992

Authors and Affiliations

  • John Rawles
    • 1
  1. 1.Department of Medicine and TherapeuticsUniversity of AberdeenAberdeenUK

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