Pathophysiology and Disease Progression of Atrial Fibrillation: Importance of Achieving and Maintaining Sinus Rhythm

  1. MARC COHEN M.D., F.A.C.C.1,
  2. GERALD V. NACCARELLI M.D.2

Article first published online: 26 MAR 2008

DOI: 10.1111/j.1540-8167.2008.01134.x

Issue

Journal of Cardiovascular Electrophysiology

Journal of Cardiovascular Electrophysiology

Volume 19, Issue 8, pages 885–890, August 2008

Additional Information

How to Cite

COHEN, M. and NACCARELLI, G. V. (2008), Pathophysiology and Disease Progression of Atrial Fibrillation: Importance of Achieving and Maintaining Sinus Rhythm. Journal of Cardiovascular Electrophysiology, 19: 885–890. doi: 10.1111/j.1540-8167.2008.01134.x

Author Information

  1. 1

    Newark Beth Israel Medical Center, Newark, New Jersey, USA

  2. 2

    Penn State Heart & Vascular Institute, Hershey, Pennsylvania, USA

*Address for correspondence: Marc Cohen, M.D., F.A.C.C., Director, Division of Cardiology, Newark Beth Israel Medical Center, 201 Lyons Avenue at Osborne Terrace, Newark, NJ 07112. Fax: 973-282-0839; E-mail: marcohen@sbhcs.com

  1. Funding for editorial support was provided by sanofi-aventis US.

  2. Dr. Cohen is a coinvestigator in the CRESCENDO trial and serves on the medical advisory board of sanofi-aventis.

  3. Dr. Naccarelli is an investigator on research grants from sanofi-aventis, Cardiome, ARYX, Wyeth-Ayerst, Boehringer-Ingleheim, and Reliant. He serves on the medical advisory boards of Xantion, Wyeth-Ayerst, Astellas, Cardiome, sanofi-aventis, Reliant, and CV Therapeutics.

  4. Manuscript received 17 December 2007; Accepted for publication 24 December 2007.

  5. Editor: Stephen C. Hammill, M.D.

Publication History

  1. Issue published online: 22 JUL 2008
  2. Article first published online: 26 MAR 2008

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Keywords:

  • atrial fibrillation;
  • pathophysiology;
  • antiarrhythmia agents;
  • rhythm control;
  • ion channels;
  • disease progression

Atrial fibrillation (AF) is a progressive disease in which arrhythmia-induced remodeling facilitates evolution from paroxysmal AF to persistent and permanent AF. Changes in electrical, structural, and contractile properties of cardiac tissue that are thought to underlie AF maintenance and progression are reviewed. Also examined is the negative impact of AF on clinical outcomes, as well as the potential benefits of restoration and maintenance of sinus rhythm. Because of the limited efficacy and adverse effects of current antiarrhythmics, new antiarrhythmic drugs need to be developed that provide safer and more effective rhythm control in AF.

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