The importance of focal pulmonary vein triggers has been highlighted in multiple studies, but alternative and nonmutually exclusive mechanisms have also been evaluated.
A focal origin of AF is supported by several experimental models showing that AF persists only in isolated regions of atrial myocardium.
Although it is possible to reverse the progression from paroxysmal to persistent and to long-standing persistent, this task can be challenging.
Permanent AF is recognized as the accepted rhythm, and the main treatment goals are rate control and anticoagulation.
Furthermore, the long-term risks of stroke and all-cause mortality were similar between participants without a secondary precipitant and those with secondary precipitants.
Thus, long-term AF screening strategies can be considered in these patients similar to the current standard of practice for patients with cryptogenic stroke.
The definition of lone AF remains controversial, but it generally refers to paroxysmal, persistent, or permanent AF in younger patients ( For patient education resources, see Heart Health Center and Brain and Nervous System Center, as well as Atrial Fibrillation (AFib), Arrhythmias (Heart Rhythm Disorders), Stroke, and Supraventricular Tachycardia (SVT, PSVT).
Contractile remodeling is caused mainly by impaired calcium handling and may result in atrial mechanical dysfunction that may be transient or progress to irreversible dysfunction.