AF can be asymptomatic or lead to symptoms such as palpitations, dyspnoea, and dizziness. Finally, we discuss recent data regarding fibrosis biomarkers that could help diagnose atrial fibrotic substrates.Ītrial fibrillation (AF) is the most common sustained arrhythmia and is associated with a substantial economic burden and significant morbidity and mortality ( 1, 2). ![]() We also describe the risk factors for its development and how to diagnose its presence using imaging, electrocardiograms, and electroanatomic voltage mapping. ![]() In this review, we summarize the current knowledge on the pathophysiology, etiology, and electrophysiological aspects of atrial substrates promoting the development of AF. Although atrial substrate evaluation remains complex, several diagnostic resources allow for a more comprehensive assessment and quantification of the extent of left atrial structural remodeling and the presence of atrial fibrosis. Nowadays is one of the most common cardiac ablation procedures performed worldwide, with its success inversely related to the extent of atrial structural disease. Catheter ablation of AF has developed into an essential rhythm-control strategy. Rigorous assessment of the presence and degree of an atrial arrhythmic substrate is essential for determining treatment options, predicting long-term success after catheter ablation, and as a substrate critical in the pathophysiology of atrial thrombogenesis. 4Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, NetherlandsĪtrial fibrillation (AF) is the most common sustained arrhythmia in the population and is associated with a significant clinical and economic burden.3Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal.2Lisbon School of Medicine, Universidade de Lisboa, Lisbon, Portugal. ![]()
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