Mécanismes physiopathologiques de la fibrillation auriculaire

Abstract

SummaryThe pathophysiology of atrial fibrillation is complex, and appears to result from the interaction between initiating triggers, often in the form of rapidly firing ectopic foci located in the pulmonary veins, and an abnormal atrial tissue substrate capable of maintaining the arrhythmia through mechanisms such as multiple wavelet reentry or multiple rotors. Moreover, atrial remodelling, autonomic tone variations and inflammation also may be involved in the genesis and maintenance of atrial fibrillation. Ultimately, the recent understanding of some of these mechanisms has led to new therapeutic strategies, such as radiofrequency catheter and surgical ablation techniques. At the present time, a strategy of radiofrequency catheter ablation tailored to the burden of atrial fibrillation allows efficient management of patients, with a high rate of long-term freedom from recurrence of atrial fibrillation.