Polovina Marija M, Potpara Tatjana S
Cardiology Clinic, Clinical Center of Serbia, 26 Visegradska, 11 000 Belgrade, Serbia.
Recent Pat Cardiovasc Drug Discov. 2013 Aug;8(2):112-26. doi: 10.2174/15748901113089990016.
Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia in clinical practice associated with significant morbidity and mortality. With the growing number of the affected individuals, the development of safe and effective treatment options for AF has become a worldwide priority. Currently available antiarrhythmic medications for the restoration and maintenance of sinus rhythm have limitations due to the modest efficacy and a potential for adverseeffects. Although substantial progress has been made in AF-ablation techniques, broad application of these nonpharmacological treatment modalities is limited and antiarrhythmic drug treatment is still the cornerstone and the first-line therapy for the majority of AF patients. Improvements in the understanding of the principal pathophysiological mechanisms of AF obtained in the last several years have provided promising treatment opportunities. New therapeutic options are based on the more selective targeting of ion channels and intercellular connection proteins predominantly expressed in the atria, the restoration of intracellular Ca(2+) homeostasis and the prevention of AF-associated electrical and structural remodeling. In this review, we provide a highlight of the most important pathophysiological mechanisms in AF with a relation to the potential therapeutic interventions, and discuss novel findings regarding the current and future pharmacological AF management and recent patents.
心房颤动（AF）是临床实践中最常见的持续性心律失常，与显著的发病率和死亡率相关。随着受影响个体数量的增加，开发安全有效的房颤治疗方案已成为全球优先事项。目前用于恢复和维持窦性心律的抗心律失常药物存在局限性，因为其疗效一般且有产生不良反应的可能性。尽管房颤消融技术已取得重大进展，但这些非药物治疗方式的广泛应用受到限制，抗心律失常药物治疗仍是大多数房颤患者的基石和一线治疗方法。过去几年在对房颤主要病理生理机制的认识上取得的进展提供了有前景的治疗机会。新的治疗选择基于更具选择性地靶向主要在心房表达的离子通道和细胞间连接蛋白、恢复细胞内Ca(2+) 稳态以及预防房颤相关的电和结构重塑。在本综述中，我们重点介绍与潜在治疗干预相关的房颤最重要的病理生理机制，并讨论有关当前和未来房颤药物治疗管理的新发现以及近期专利。
