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EDITORIAL

Mechanisms of atrial fibrillation: is a cure at hand?

^a Department of Medicine and the Cardiovascular Research Institute, University of California, San Francisco, California, USA

Manuscript received October 1, 1999; revised manuscript received November 18, 1999, accepted January 13, 2000.

Reprint requests and correspondence: Dr. Melvin M. Scheinman, 500 Parnassus Avenue, San Francisco, California 94143-1354
scheinman{at}ep4.ucsf.edu

The mechanisms of atrial fibrillation relate to the presence of random reentry involving multiple interatrial circuits. Triggers for development of atrial fibrillation include rapidly discharging atrial foci (mainly from pulmonary veins) or degeneration of atrial flutter or atrial tachycardia into fibrillation. Therapy for control of atrial fibrillation includes drugs, atrial pacing for those with sinus node dysfunction, or ablation of the atrioventricular junction. Therapeutic maneuvers for cure of atrial fibrillation include surgical or radiofrequency catheter induced linear lesions to reduce the atrial tissue and prevent the requisite number of reentrant wavelets. We need a much better understanding of basic mechanisms before a true cure is at hand.

Abbreviations and Acronyms   AFib = atrial fibrillation   AV = atrioventricular   ECG = electrocardiogram

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