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Previous Volume 344:1067-1078 April 5, 2001 Number 14 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Electrocardiographically, atrial fibrillation is characterized by the presence of rapid, irregular, fibrillatory waves that vary in size, shape, and timing. This set of findings is usually associated with an irregular ventricular response, although regularization may occur in patients with complete heart block, an accelerated junctional or idioventricular rhythm, or a ventricular paced rhythm. In the past decade, we have gained a greater understanding of atrial fibrillation. Experimental studies have explored the mechanisms of the onset and maintenance of the arrhythmia; drugs have been tailored to specific cardiac ion channels; nonpharmacologic therapies have been introduced that are designed to control or . . . [Full Text of this Article]

Epidemiology

Histologic and Electrophysiologic Features

Hemodynamic Effects

Symptoms

Approach to the Patient with Atrial Fibrillation

Newly Diagnosed Atrial Fibrillation

Antiarrhythmic-Drug Therapy

Anticoagulation

Recurrent Paroxysmal Atrial Fibrillation

Antiarrhythmic-Drug Therapy

Persistent Atrial Fibrillation

Cardioversion

Long-Term Anticoagulation

Heart-Rate Control

Drug-Refractory Atrial Fibrillation

Ablation of the Atrioventricular Node and Implantation of a Pacemaker

Focal Ablation

The Maze Procedure

Pacemaker Therapy

Implantable Atrial Defibrillators

Conclusions

Source Information

From the Section of Cardiology, Boston Medical Center, Boston.

Address reprint requests to Dr. Falk at the Boston Medical Center, Section of Cardiology, 88 E. Newton St., Boston, MA 02118, or at rfalk@bu.edu.

References

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• Santos, U P, Terra-Filho, M, Lin, C A, Pereira, L A A, Vieira, T C B, Saldiva, P H N, Braga, A L F (2008). Cardiac arrhythmia emergency room visits and environmental air pollution in Sao Paulo, Brazil. J. Epidemiol. Community Health 62: 267-272 [Abstract] [Full Text]  
• Soran, H., Younis, N., Currie, P., Silas, J., Jones, I.R., Gill, G. (2008). Influence of diabetes on the maintenance of sinus rhythm after a successful direct current cardioversion in patients with atrial fibrillation. QJM 101: 181-187 [Abstract] [Full Text]  
• Tozzi, P., Hayoz, D., Thevenaz, P., Roulet, J.-Y., Salchli, F., von Segesser, L. K. (2008). Atria assist device to restore transport function of fibrillating atrium. Eur. J. Cardiothorac. Surg. 33: 263-267 [Abstract] [Full Text]  
• Issac, T. T., Dokainish, H., Lakkis, N. M. (2007). Role of Inflammation in Initiation and Perpetuation of Atrial Fibrillation: A Systematic Review of the Published Data. J Am Coll Cardiol 50: 2021-2028 [Abstract] [Full Text]  
• Nutescu, E. A. (2007). ASHP Therapeutic Position Statement on Antithrombotic Therapy in Chronic Atrial Fibrillation. Am J Health Syst Pharm 64: 2281-2291 [Full Text]  
• Kim, Y. H., Lee, S.-C., Her, A. Y., Kim, H. J., Choi, J. O., Shin, D. H., Cho, S. W., Lee, W. S., Park, S. W., Park, P. W. (2007). Preoperative left atrial volume index is a predictor of successful sinus rhythm restoration and maintenance after the maze operation. J. Thorac. Cardiovasc. Surg. 134: 448-453 [Abstract] [Full Text]  
• Wierup, P., Liden, H., Johansson, B., Nilsson, M., Edvardsson, N., W.-O. Berglin, E. (2007). Health Care Consumption Due to Atrial Fibrillation is Markedly Reduced by Maze III Surgery. Ann. Thorac. Surg. 83: 1713-1716 [Abstract] [Full Text]  
• Goodman, S., Shirov, T., Weissman, C. (2007). Supraventricular Arrhythmias in Intensive Care Unit Patients: Short and Long-Term Consequences. Anesth. Analg. 104: 880-886 [Abstract] [Full Text]  
• Gillinov, A. M. (2007). Advances in Surgical Treatment of Atrial Fibrillation. Stroke 38: 618-623 [Abstract] [Full Text]  
• Bakir, I., Casselman, F. P., Brugada, P., Geelen, P., Wellens, F., Degrieck, I., Van Praet, F., Vermeulen, Y., De Geest, R., Vanermen, H. (2007). Current Strategies in the Surgical Treatment of Atrial Fibrillation: Review of the Literature and Onze Lieve Vrouw Clinic's Strategy. Ann. Thorac. Surg. 83: 331-340 [Abstract] [Full Text]  
• Jeanmart, H., Casselman, F., Beelen, R., Wellens, F., Bakir, I., Van Praet, F., Cammu, G., Degriek, Y., Vermeulen, Y., Vanermen, H. (2006). Modified Maze During Endoscopic Mitral Valve Surgery: The OLV Clinic Experience. Ann. Thorac. Surg. 82: 1765-1769 [Abstract] [Full Text]  
• Van Gelder, I. C., Hemels, M. E.W. (2006). The progressive nature of atrial fibrillation: a rationale for early restoration and maintenance of sinus rhythm. Europace 8: 943-949 [Abstract] [Full Text]  
• Olson, T. M., Alekseev, A. E., Liu, X. K., Park, S., Zingman, L. V., Bienengraeber, M., Sattiraju, S., Ballew, J. D., Jahangir, A., Terzic, A. (2006). Kv1.5 channelopathy due to KCNA5 loss-of-function mutation causes human atrial fibrillation. Hum Mol Genet 15: 2185-2191 [Abstract] [Full Text]  
• Gulizia, M., Mangiameli, S., Chiaranda, G., Spadola, V., Di Giovanni, N., Colletti, A., Bulla, V., Circo, A., Pensabene, O., Vasquez, L., Vaccaro, I., Grammatico, A., on behalf of PITAGORA Study Investigators, (2006). Design and rationale of a randomized study to compare amiodarone and Class IC anti-arrhythmic drugs in terms of atrial fibrillation treatment efficacy in patients paced for sinus node disease: the PITAGORA trial.. Europace 8: 302-305 [Abstract] [Full Text]  
• Wazni, O, Martin, D O, Marrouche, N F, Shaaraoui, M, Chung, M K, Almahameed, S, Schweikert, R A, Saliba, W I, Natale, A (2005). C reactive protein concentration and recurrence of atrial fibrillation after electrical cardioversion. Heart 91: 1303-1305 [Abstract] [Full Text]  
• Dixon, B. J., Bracha, Y., Loecke, S. W., Guerrero, M. A., Taylor, R. D., Asinger, R. W. (2005). Principal Atrial Fibrillation Discharges by the New ACC/AHA/ESC Classification. Arch Intern Med 165: 1877-1881 [Abstract] [Full Text]  
• Byrd, G. D., Prasad, S. M., Ripplinger, C. M., Cassilly, T. R., Schuessler, R. B., Boineau, J. P., Damiano, R. J. Jr (2005). Importance of Geometry and Refractory Period in Sustaining Atrial Fibrillation: Testing the Critical Mass Hypothesis. Circulation 112: I-7-I-13 [Abstract] [Full Text]  
• Kahaly, G. J., Dillmann, W. H. (2005). Thyroid Hormone Action in the Heart. Endocr. Rev. 26: 704-728 [Abstract] [Full Text]  
• McKeown, P. P. (2005). Introduction: American College of Chest Physicians Guidelines for the Prevention and Management of Postoperative Atrial Fibrillation After Cardiac Surgery. Chest 128: 6S-8S [Abstract] [Full Text]  
• Lam, B-K., Boodhwani, M., Veinot, J. P., Hendry, P. J., Mesana, T. G. (2005). Surgical treatment of atrial fibrillation with diathermy: an in vitro study. Eur. J. Cardiothorac. Surg. 27: 456-461 [Abstract] [Full Text]  
• Izhar, U., Ad, N., Rudis, E., Milgalter, E., Korach, A., Viola, N., Levi, E., Asraff, G., Merin, G., Elami, A. (2005). When should we discontinue antiarrhythmic therapy for atrial fibrillation after coronary artery bypass grafting? A prospective randomized study. J. Thorac. Cardiovasc. Surg. 129: 401-406 [Abstract] [Full Text]  
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• Humphries, K. H., Kerr, C. R., Steinbuch, M., Dorian, P., for The Canadian Registry of Atrial Fibrillation, (2004). Limitations to antiarrhythmic drug use in patients with atrial fibrillation. CMAJ 171: 741-745 [Abstract] [Full Text]  
• Palin, C. A., Kailasam, R., Hogue, C. W. Jr (2004). Atrial Fibrillation After Cardiac Surgery: Pathophysiology and Treatment. SEMIN CARDIOTHORAC VASC ANESTH 8: 175-183 [Abstract]  
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• Djaiani, G., Phillips-Bute, B., Podgoreanu, M., Messier, R. H., Mathew, J. P., Clements, F., Newman, M. F. (2004). The Association of Patent Foramen Ovale and Atrial Fibrillation After Coronary Artery Bypass Graft Surgery. Anesth. Analg. 98: 585-589 [Abstract] [Full Text]  
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• Aviles, R. J., Martin, D. O., Apperson-Hansen, C., Houghtaling, P. L., Rautaharju, P., Kronmal, R. A., Tracy, R. P., Van Wagoner, D. R., Psaty, B. M., Lauer, M. S., Chung, M. K. (2003). Inflammation as a Risk Factor for Atrial Fibrillation. Circulation 108: 3006-3010 [Abstract] [Full Text]  
• Boos, C.J., Carlsson, J., More, R.S. (2003). Rate or rhythm control in persistent atrial fibrillation?. QJM 96: 881-892 [Abstract] [Full Text]  
• Singer, D. E. (2003). A 60-Year-Old Woman With Atrial Fibrillation. JAMA 290: 2182-2189 [Full Text]  
• Lacomis, J. M., Wigginton, W., Fuhrman, C., Schwartzman, D., Armfield, D. R., Pealer, K. M. (2003). Multi-Detector Row CT of the Left Atrium and Pulmonary Veins before Radio-frequency Catheter Ablation for Atrial Fibrillation. RadioGraphics 23: S35-48 [Abstract] [Full Text]  
• Woodard, P. K., Lacomis, J. M., Fuhrman, C. R. (2003). Invited Commentary * Authors' Response. RadioGraphics 23: S48-50 [Full Text]  
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• Wyse, D. G. (2003). Rhythm management in atrial fibrillation: less is more. J Am Coll Cardiol 41: 1703-1706 [Full Text]  
• Letelier, L. M., Udol, K., Ena, J., Weaver, B., Guyatt, G. H. (2003). Effectiveness of Amiodarone for Conversion of Atrial Fibrillation to Sinus Rhythm: A Meta-analysis. Arch Intern Med 163: 777-785 [Abstract] [Full Text]  
• Essebag, V., Hadjis, T., Platt, R. W., Pilote, L. (2003). Amiodarone and the risk of bradyarrhythmia requiring permanent pacemaker in elderly patients with atrial fibrillation and prior myocardial infarction. J Am Coll Cardiol 41: 249-254 [Abstract] [Full Text]  
• The Atrial Fibrillation Follow-up Investigation of, (2002). A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation. NEJM 347: 1825-1833 [Abstract] [Full Text]  
• Van Gelder, I. C., Hagens, V. E., Bosker, H. A., Kingma, J. H., Kamp, O., Kingma, T., Said, S. A., Darmanata, J. I., Timmermans, A. J.M., Tijssen, J. G.P., Crijns, H. J.G.M., the Rate Control versus Electrical Cardioversion f, (2002). A Comparison of Rate Control and Rhythm Control in Patients with Recurrent Persistent Atrial Fibrillation. NEJM 347: 1834-1840 [Abstract] [Full Text]  
• Gillinov, A. M., Blackstone, E. H., McCarthy, P. M. (2002). Atrial fibrillation: current surgical options and their assessment. Ann. Thorac. Surg. 74: 2210-2217 [Abstract] [Full Text]  
• Reis, S., Hermoni, D., Livingstone, P., Borkan, J. (2002). Integrated narrative and evidence based case report: Case report of paroxysmal atrial fibrillation and anticoagulation. BMJ 325: 1018-1020 [Full Text]  
• Amar, D., Heerdt, P. M., Korst, R. J., Zhang, H., Nguyen, H. (2002). The Effects of Advanced Age on the Incidence of Supraventricular Arrhythmias After Pneumonectomy in Dogs. Anesth. Analg. 94: 1132-1136 [Abstract] [Full Text]  
• El Gendi, H., Wasan, B., Mayet, J., Gilligan, D. M., Falk, R. H. (2001). Atrial Fibrillation. NEJM 345: 620-621 [Full Text]  
• Belknap, S. (2001). Rate and rhythm control showed similar symptom improvement in atrial fibrillation. Evid. Based Med. 6: 113-113 [Full Text]