Abstract
Heart failure (HF) frequently coexists with atrial fibrillation (AF) and dysfunction of the sinoatrial node (SAN), the natural pacemaker. HF is associated with chronic adrenergic stimulation, neurohormonal activation, abnormal intracellular calcium handling, elevated cardiac filling pressure and atrial stretch, and fibrosis. Pulmonary veins (PVs), which are the points of onset of ectopic electrical activity, are the most crucial AF triggers. A crosstalk between the SAN and PVs determines PV arrhythmogenesis. HF has different effects on SAN and PV electrophysiological characteristics, which critically modulate the development of AF and sick sinus syndrome. This review provides updates to improve our current understanding of the effects of HF in the electrical activity of the SAN and PVs as well as therapeutic implications for AF.
Original language | English |
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Article number | 3224 |
Journal | International Journal of Molecular Sciences |
Volume | 20 |
Issue number | 13 |
DOIs | |
Publication status | Published - Jul 1 2019 |
Keywords
- Atrial fibrillation
- Heart failure
- Pulmonary veins
- Sinoatrial node
- Sinoatrial node dysfunction
- Heart Failure/drug therapy
- Animals
- Pulmonary Veins/drug effects
- Humans
- Sinoatrial Node/drug effects
- Atrial Fibrillation/drug therapy
- Anti-Arrhythmia Agents/pharmacology
ASJC Scopus subject areas
- Molecular Biology
- Spectroscopy
- Catalysis
- Inorganic Chemistry
- Computer Science Applications
- Physical and Theoretical Chemistry
- Organic Chemistry