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Atrial fibrillation in different clinical subsets 

Atrial fibrillation in different clinical subsets
Chapter:
Atrial fibrillation in different clinical subsets
Source:
Management of Atrial Fibrillation (Oxford Cardiology Library): A Practical Approach
Author(s):

Mohammad Shenasa

, Hossein Shenasa

, and Shahrzad Rouhani

DOI:
10.1093/med/9780199686315.003.0004

Atrial fibrillation (AF) is the most common rhythm disturbance with diverse aetiologies, among which age, hypertension, and heart failure are the most important. AF also has an intricate mechanism with a complex interplay between triggers and substrates that are in nature evolving. Because of this there exists individual variability leading to significant morbidity and mortality rates and economic burden. Due to its complex and progressive nature, management remains challenging and often unsatisfactory and prompts unexpected medication changes, multiple procedures, frequent hospitalization, high incidences of heart failure and stroke, and hampers the quality of life. Therefore, management should be targeted towards early detection, modification of structural heart diseases, and prevention of cardiac remodelling and its complications. AF should not be regarded as one entity but related to multiple structural heart diseases. AF and heart failure have emerged as an epidemic of the twenty-first century and together are called the ‘deadly duo’; therefore, evidence-based personalized management according to the guidelines is warranted. Physicians should inform and educate patients about the importance of AF’s relationship with heart failure and stroke as well as medication adherence.

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