Catheter Ablation for Atrial Fibrillation: The Tailored Approach
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 18, Issue 5
Abstract
The study of atrial fibrillation (AF) pathophysiology represents a challenge that is not yet completely understood. The first studies date back to the early twentieth century, but the fundamental steps that have led to current knowledge on this arrhythmia have developed in the last 25 years. In 1924 Garrey [1] published a review on the “auricular fibrillation” indicating the mechanisms considered responsible for AF. The author proposed three main models in which this arrhythmia was sustained: multiple or single ectopic foci with fibrillation conduction, a single re-entry circuit (defined mother wave) with fibrillation conduction and multiple simultaneous re-entry circuits [1]. Between the end of the 60s and the early 70s, Coumel postulated the concept of the triangle needed to support every type of arrhythmia: triggers, arrhythmogenic substrate and modulating factors. In this model, although historically dated, atrial fibrillation still fits adequately. These mechanisms have been proposed to play a crucial role in the AF genesis and every part of the triangle may coexist in the same patients [2].
Authors and Affiliations
Luigi Sciarra, Zefferino Palamà, Martina Nesti
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