Atrial fibrillation: primary prevention, secondary prevention, and prevention of thromboembolic complications: part 1

Abstract

Atrial fibrillation (AF), is the most common sustained cardiac arrhythmia. It was once thought to be benign as long as the ventricular rate was controlled, however, AF is associated with significant cardiac morbidity and mortality. Increasing life expectancy driven by improved health care and decreased fertility rates has, in most of the world, resulted in the population aged ≥65 years growing more rapidly than the overall population. As the population ages, projections suggest that the burden of AF may increase more than 60% by 2050. Although considerable progress has been made in the treatment and management of AF, primary prevention, secondary prevention, and prevention of thromboembolic complications remain a work in progress. This narrative review was facilitated by a MEDLINE search to identify peer-reviewed clinical trials, randomized controlled trials, meta-analyses, and other clinically relevant studies. The search was limited to English-language reports published between 1950 and 2021. Atrial fibrillation was searched via the terms primary prevention, hyperthyroidism, Wolff-Parkinson-White syndrome, catheter ablation, surgical ablation, hybrid ablation, stroke prevention, anticoagulation, left atrial occlusion and atrial excision. Google and Google scholar as well as bibliographies of identified articles were reviewed for additional references. In these two manuscripts, we discuss the current strategies available to prevent AF, then compare noninvasive and invasive treatment strategies to diminish AF recurrence. In addition, we examine the pharmacological, percutaneous device and surgical approaches to prevent stroke as well as other types of thromboembolic events.

Features of the Course of Atrial Fibrillation in Patients with the History of COVID-19: Impact on the Possibility and Tactics of Restoring Sinus Rhythm

“…Кількість пацієнтів із ФП дуже низька серед молодих людей (< 1 % у людей віком < 40 років), але зростає з віком, досягаючи від 10 % до 17 % у осіб старше 80 років. З огляду на старіння населення в усьому світі, тягар ФП може зрости більш ніж на 60 % [4,5]. Майже 20 % пацієнтів із перенесеною КІ мають ФП в анамнезі, а у пацієнтів після перенесеної інфекції COVID-19 частота нової ФП становить від 10 % до 18 % [6].…”

The application and mechanism of Chinese medicine in the upstream treatment of atrial fibrillation

“…The high incidence of AF in aging societies, the disabling and fatal nature of thromboembolic complications in stroke, and the chronic, long-lasting, and recurrent nature of the disease indicate an urgent need for noninvasive, convenient, reliable, and safe therapies. However, existing treatments for AF, such as drugs and ablation procedures, are prone to side effects, complications, and high surgical recurrence rates, all with their limitations ( 1 , 2 ). Currently, we generally pay more attention to the ablation treatment of pulmonary venous sleeve, research found that the pathogenesis of atrial fibrillation is not limited to this, atrial fibrosis, inflammation, ionic currents and channels, oxidative stress, atrial remodeling, RAAS, and autonomic nervous system are closely related to the occurrence and maintenance of AF, but its research is limited.…”