ATRIAL-FIBRILLATION - CURRENT UNDERSTANDINGS AND RESEARCH IMPERATIVES

Atrial fibrillation is the most common sustained cardiac arrhythmia en countered in clinical practice. Atrial fibrillation increases with age and is relatively common (> 5%) in patients > 69 years old. Despite t his, our understanding of the underlying electrophysiologic mechanisms and the optimal management remains incomplete. This arrhythmia is see n most frequently in association with coronary disease or hypertension , but it is also frequently a consequence of rheumatic heart disease. The mechanism of atrial fibrillation requires further elucidation, but the most widely accepted hypothesis is a multiple reentrant wavelet m echanism. The treatment of atrial fibrillation is undertaken to reduce the risk of stroke or systemic embolus, to control palpitation or oth er symptoms or to improve exercise tolerance or treat pulmonary conges tion. This report is a discussion of the epidemiology of atrial fibril lation and of the etiology, mechanism, management and future research directions in the study of this arrhythmia.