2014/01/01 by Jonathan W. Waks, Mark E. Josephson · 1 citation
Medicine · #Atrial Fibrillation Management and Outcomes #Cardiac Arrhythmias and Treatments #Cardiac electrophysiology and arrhythmias
paper · pdf · doi:10.15420/aer.2014.3.2.90
openalex publication_date 2014/01/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/28
Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice, yet our understanding of the mechanisms that initiate and sustain this arrhythmia remains quite poor. Over the last 50 years, various mechanisms of AF have been proposed, yet none has been consistently observed in both experimental studies and in humans. Recently, there has been increasing interest in understanding how spiral waves or rotors - which are specific, organised forms of functional reentry - sustain human AF and how they might be therapeutic targets for catheter-based ablation. The following review describes the historical understanding of reentry and AF mechanisms from earlier in the 20th century, advances in our understanding of mechanisms that are able to sustain AF with a focus on rotors and complex fractionated atrial electrograms (CFAEs), and how the study of AF mechanisms has resulted in new strategies for treating AF with novel forms of catheter ablation.