TY - JOUR
T1 - Atrial Fibrillation
T2 - JACC Council Perspectives
AU - ACC Electrophysiology Section Leadership Council
AU - Chung, Mina K.
AU - Refaat, Marwan
AU - Shen, Win Kuang
AU - Kutyifa, Valentina
AU - Cha, Yong Mei
AU - Di Biase, Luigi
AU - Baranchuk, Adrian
AU - Lampert, Rachel
AU - Natale, Andrea
AU - Fisher, John
AU - Lakkireddy, Dhanunjaya R.
N1 - Funding Information:
Dr. Kutyifa has received research grants from Boston Scientific, ZOLL, and Biotronik; and has received consultant fees from Biotronik and ZOLL. Dr. Di Biase has served as a consultant to Medtronic, Biotronik, BWI, and Boston Scientific; and has received speaker/travel honoraria from Biosense Webster, St. Jude Medical (now Abbott), Boston Scientific, Medtronic, Biotronik, Pfizer, and Bristol-Myers Squibb. Dr. Baranchuk has received grants from Medtronic, Abbot, and Bayer; and has received honoraria from Medtronic, Abbot, Bayer, Pfizer, and Bristol-Myers Squibb. Dr. Lampert has received modest consulting honoraria and significant research grants from Medtronic; has received a significant research grant from St. Jude/Abbott; and has received a modest research grant (in kind) from Amgen. Dr. Natale has received consulting fees and honoraria from Medtronic, Boston Scientific, BWI, Baylis, and Abbott. Dr. Fisher has served as a consultant for Medtronic. Dr. Lakkireddy has served as a consultant for Abbott, Biotronik, BWI, Atricure, Northeast Scientific, Acutus, and Lifetech. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Funding Information:
Dr. Kutyifa has received research grants from Boston Scientific, ZOLL, and Biotronik; and has received consultant fees from Biotronik and ZOLL. Dr. Di Biase has served as a consultant to Medtronic, Biotronik, BWI, and Boston Scientific; and has received speaker/travel honoraria from Biosense Webster, St. Jude Medical (now Abbott), Boston Scientific, Medtronic, Biotronik, Pfizer, and Bristol-Myers Squibb. Dr. Baranchuk has received grants from Medtronic, Abbot, and Bayer; and has received honoraria from Medtronic, Abbot, Bayer, Pfizer, and Bristol-Myers Squibb. Dr. Lampert has received modest consulting honoraria and significant research grants from Medtronic; has received a significant research grant from St. Jude/Abbott; and has received a modest research grant (in kind) from Amgen. Dr. Natale has received consulting fees and honoraria from Medtronic, Boston Scientific, BWI, Baylis, and Abbott. Dr. Fisher has served as a consultant for Medtronic. Dr. Lakkireddy has served as a consultant for Abbott, Biotronik, BWI, Atricure, Northeast Scientific, Acutus, and Lifetech. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Publisher Copyright:
© 2020
PY - 2020/4/14
Y1 - 2020/4/14
N2 - Atrial fibrillation (AF) is an increasingly prevalent arrhythmia; its pathophysiology and progression are well studied. Stroke and bleeding risk models have been created and validated. Decision tools for stroke prophylaxis are evolving, with better options at hand. Utilization of various diagnostic tools offer insight into AF burden and thromboembolic risk. Rate control, rhythm control, and stroke prophylaxis are the cornerstones of AF therapy. Although antiarrhythmic drugs are useful, AF ablation has become a primary therapeutic strategy. Pulmonary vein isolation is the cornerstone of AF ablation, and methods to improve ablation safety and efficacy continue to progress. Ablation of nonpulmonary vein sites is increasingly being recognized as an important strategy for treating nonparoxysmal AF. Several new ablation techniques and technologies and stroke prophylaxis are being explored. This is a contemporary review on the prevalence, pathophysiology, risk prediction, prophylaxis, treatment options, new insights for optimizing treatment outcomes, and emerging concepts of AF.
AB - Atrial fibrillation (AF) is an increasingly prevalent arrhythmia; its pathophysiology and progression are well studied. Stroke and bleeding risk models have been created and validated. Decision tools for stroke prophylaxis are evolving, with better options at hand. Utilization of various diagnostic tools offer insight into AF burden and thromboembolic risk. Rate control, rhythm control, and stroke prophylaxis are the cornerstones of AF therapy. Although antiarrhythmic drugs are useful, AF ablation has become a primary therapeutic strategy. Pulmonary vein isolation is the cornerstone of AF ablation, and methods to improve ablation safety and efficacy continue to progress. Ablation of nonpulmonary vein sites is increasingly being recognized as an important strategy for treating nonparoxysmal AF. Several new ablation techniques and technologies and stroke prophylaxis are being explored. This is a contemporary review on the prevalence, pathophysiology, risk prediction, prophylaxis, treatment options, new insights for optimizing treatment outcomes, and emerging concepts of AF.
KW - atrial fibrillation
KW - future
KW - present
UR - http://www.scopus.com/inward/record.url?scp=85082558264&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85082558264&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2020.02.025
DO - 10.1016/j.jacc.2020.02.025
M3 - Review article
C2 - 32273035
AN - SCOPUS:85082558264
SN - 0735-1097
VL - 75
SP - 1689
EP - 1713
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 14
ER -