Atriopathy and atrial fibrillation. Part I

Abstract

Atrial fibrillation is the most common supraventricular tachycardia, the incidence of which increases with age. This arrhythmia is the consequenсe of multiple cardiac and noncardiac pathology. The most significant side effects of atrial fibrillation are thromboembolic complications. It is generally accepted that the source of these embolisms is a thrombus in the left atrial appendage. However, the risk of thromboembolism also occurs after the onset of atrial rhythm, which can lead to a more complex hemostasis mechanism in this disease. There is no unambiguous definition of the relationship between structural and functional changes in the atria and atrial fibrillation, which manifests itself in the appearance of treatment. Essential methods of catheter operations in patients with atrial fibrillation do not take into account the peculiarities of the rhythm mechanism, which has an influence on the treatment’s results. The first part of the review reflects the anatomy, histology, and physiology of atria, their main cellular elements, and electrophysiological features. The main experimental and clinical models of arrhythmia are described; as factors provoking atrial fibrillation and mechanisms of its stabilization. The analysis of electrophysiological and structural remodeling. The concepts of atriopathy and atrial cardiomyopathy are discussed, and classification is given. The mechanisms of hemostasis disorders and possible directions of correction are presented.