Algalarrondo Vincent, Extramiana Fabrice
AP-HP, service de cardiologie, hôpital Bichat-Claude-Bernard, Paris, France ; université de Paris, Paris, France.
Rev Prat. 2020 Oct;70(8):894-898.
Epidemiology and pathophysiology of atrial fibrillation. Atrial fibrillation (AF) is the most common clinically significant cardiac arrhythmia worldwide. Its incidence and prevalence (currently 1 to 4% of the world population) are increasing. Most of the cardiovascular risk factors increase the risk of developing AF. AF is associated with a doubling risk of total mortality; it increases also the risk of stroke by 4-5 fold and therefore represents a public health problem. Mechanistically, the anarchic electrical activity recorded in the atrium in AF can be triggered by arrhythmogenic foci located in the pulmonary veins. In persistent AF, deep alterations in cellular electrophysiology, calcium metabolism, and extracellular matrix are observed, which tend to perpetuate the arrhythmia.
心房颤动的流行病学与病理生理学。心房颤动(AF)是全球临床上最常见且具有重要意义的心律失常。其发病率和患病率(目前占世界人口的1%至4%)正在上升。大多数心血管危险因素会增加发生AF的风险。AF与总死亡率翻倍的风险相关;它还使中风风险增加4至5倍,因此是一个公共卫生问题。从机制上讲,AF时心房中记录到的无规律电活动可由肺静脉中的致心律失常病灶触发。在持续性AF中,可观察到细胞电生理学、钙代谢和细胞外基质的深度改变,这些改变往往会使心律失常持续存在。