Clinical and therapeutic implications of remodeling in atrial fibrillation

PhD ceremony: Ms. M.D. Smit, 14.45 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Clinical and therapeutic implications of remodeling in atrial fibrillation

Promotor(s): prof. I.C. van Gelder, prof. D.J. van Veldhuisen

Faculty: Medical Sciences

Atrial fibrillation is the most frequently occurring arrhythmia. In Europe, more than six million people suffer from atrial fibrillation and this number is expected to rise. The aim of this thesis is to investigate the clinical and therapeutic implications of remodeling in atrial fibrillation, which refers to the atrial dilatation and changes in atrial tissue due to high blood pressure, heart failure, valvular diseases and diabetes. Remodeling can be found before the patient develops atrial fibrillation, but it also reinforces the clinical damage when atrial fibrillation develops. Inflammation was found to be associated with early atrial fibrillation recurrences, that potentially may respond to anti-inflammatory treatment. In patients with permanent atrial fibrillation lenient rate control did not lead to more adverse remodeling than strict rate control. Assessment of the degree of structural remodeling is expected to be useful to identify patients who respond to treatment aimed at freezing the progression, and improving the outcome of atrial fibrillation.