Atrial Fibrillation Structural Substrates: Aetiology, Identification and Implications

Ahmed M Al-Kaisey; Ramanathan Parameswaran; Jonathan M Kalman

doi:10.15420/aer.2020.19

Atrial Fibrillation Structural Substrates: Aetiology, Identification and Implications

Arrhythm Electrophysiol Rev. 2020 Nov;9(3):113-120. doi: 10.15420/aer.2020.19.

Authors

Ahmed M Al-Kaisey^{1

2}, Ramanathan Parameswaran^{1

2}, Jonathan M Kalman^{1

2}

Affiliations

¹ Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
² Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.

Abstract

Atrial remodelling in AF underlines the electrical, structural and mechanical changes in the atria of patients with AF. Several risk factors for AF contribute to the development of the atrial substrate, with some evidence that atrial remodelling reversal is possible with targeted intervention. In this article, the authors review the electrophysiological changes that characterise the atrial substrate in patients with AF risk factors. They also discuss the pitfalls of mapping the atrial substrate and the implications for developing tailored ablation strategies to improve outcomes in patients with AF.

Keywords: AF; atrial remodelling; atrial substrate; electroanatomic mapping; low-voltage area; reverse remodelling.

Publication types

Review