Remodelling in atrial fibrillation: the impact of amiodarone

Cardiovasc J Afr. 2019;30(3):174-180. doi: 10.5830/CVJA-2019-012. Epub 2019 Mar 27.

Abstract

Atrial fibrillation (AF) is a common heart rhythm disorder with a prevalence of up to 2.9% in the general population. Its mechanism involves a particular electrophysiological profile as well as structural and biohumoral changes that are often irreversible. With the recent advances in pharmacology, amiodarone remains the cornerstone for the treatment of AF. Although it is one of the most controversial anti-arrhythmic agents due to the multitude of side effects, it is further recognised as the most effective drug available for the conversion and maintenance of sinus rhythm in the case of significant left ventricular dysfunction or severe aortic stenosis. This quality is provided by its multivalent profile, with a complex electrophysiological activity overlapped with an anti-inflammatory and vasodilatory effect. This review aims to outline the main structural and functional changes in AF and the multisite impact of amiodarone on its treatment.

Keywords: amiodarone; anti‐arrhythmic; atrial fibrillation; inflammation; remodelling.

Publication types

  • Review

MeSH terms

  • Action Potentials
  • Amiodarone / adverse effects
  • Amiodarone / therapeutic use*
  • Animals
  • Anti-Arrhythmia Agents / adverse effects
  • Anti-Arrhythmia Agents / therapeutic use*
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / metabolism
  • Atrial Fibrillation / physiopathology
  • Atrial Remodeling / drug effects*
  • Autonomic Nervous System / drug effects
  • Autonomic Nervous System / physiopathology
  • Heart Atria / drug effects*
  • Heart Atria / innervation
  • Heart Atria / metabolism
  • Heart Atria / physiopathology
  • Heart Rate / drug effects*
  • Humans
  • Inflammation Mediators / metabolism
  • Signal Transduction
  • Treatment Outcome

Substances

  • Anti-Arrhythmia Agents
  • Inflammation Mediators
  • Amiodarone