Journal
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
Volume 20, Issue 13, Pages -Publisher
MDPI
DOI: 10.3390/ijms20133224
Keywords
heart failure; atrial fibrillation; sinoatrial node dysfunction; pulmonary veins; sinoatrial node
Funding
- Ministry of Science and Technology of Taiwan [MOST107-2314-B-281-009, MOST107-2314-B-038-101-MY3]
- Taipei Medical University-Taipei Medical University Hospital [108TMU-TMUH-25]
- Taipei Medical University-Wan Fang Hospital [107-wf-eva-01, 108-wf-eva-06, 108-wf-swf-01]
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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.
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