What are the forms of atrial remodeling during a progression of atrial fibrillation (Afib) (AF)?

Updated: Apr 09, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

Three forms of atrial remodeling during a progression of atrial fibrillation (AF) have been described: electrical, contractile, and structural. [5] Electrical remodeling is a consequence of high atrial rates and includes shortening of the refractory period of atrial myocytes and slowing of atrial conduction velocity. [6] Structural remodeling is characterized both by changes in atrial myocytes [7, 8] in the interstitium, [9, 10] and by changes in extracellular matrix composition and deposition of fibrotic tissue. [11]  Changes at the level of atrial myocytes include the loss of contractile structures and expression of fetal-like proteins, and accumulation of glycogen in the atrial interstitium. [12]


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