Atrial Fibrillation-Induced Cardiomyopathy.

Sanghamitra Mohanty, Andrea Natale, Luigi Di Biase, Fengwei Zou, Hannah Levine

Journal: Cardiac electrophysiology clinics 2025;17(1):13-18

PMID: 39893034

Full Text on Elsevier Science View on PubMed

Abstract

Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias in the world. Patients with AF also suffer from heart failure (HF). The relationship between AF and HF is often considered bidirectional and both share very similar risk factors. The mechanism of AF-induced cardiomyopathy lies in 3 distinct components: tachycardia-related cardiac dysfunction, heart rhythm irregularity, and AF-induced atrial myopathy. These components are mediated by calcium mishandling, neurohormonal activation, oxidative stress, myocardial supply-demand mismatch, and irreversible fibrosis and remodeling. Managing AF-induced cardiomyopathy should focus on early rhythm control to mitigate the development of irreversible remodeling and atrial myopathy.

Address: Department of Medicine/Cardiology, Montefiore-Einstein Center for Heart & Vascular Care, Bronx, NY 10467, USA.; Department of Clinical Cardiac Electrophysiology, Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, TX 78705, USA.; Department of Medicine/Cardiology, Montefiore-Einstein Center for Heart & Vascular Care, Bronx, NY 10467, USA; Systems Head of Electrophysiology, Director of Arrhythmias at Montefiore Health System, Bronx, NY 10467, USA. Electronic address: [email protected].

DOI: 10.1016/j.ccep.2024.10.001