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Interdependent relationship between atrial fibrillation and sinus rhythm: at the hypothetical interface of atrial fibrillation, autonomic tone, sinoatrial node and inflammation (analytical review, reconsiderations, speculations and new insights)


Abstract. Underlying mechanisms of atrial fibrillation occurrence and its self-extinguishing remain not completely investigated yet. The role of autonomic tone and sinoatrial node in the interplay between atrial fibrillation and sinus rhythm is also not fully understood.  The influence of inflammation as a possible source of arrhythmia and likelihood of its pharmacologic treatment deserves special attention. These complex issues are important for better understanding of arrhythmogenesis and rhythm control. Conceptual reconsiderations through the new insights primarily on the hypothetic basis may delineate new therapeutic and preventive strategies. The aim of this analytical review was to reinforce the clinical and laboratory studies regarding the role of: 1) autonomic tone and sinoatrial node in restitution of sinus rhythm, 2) new concept of “vibrantly quiescent stroboscopic tuning” as a matured status of atrial fibrillation being prepared for its abruption by slight impulse, 3) inflammation in the interplay between atrial fibrillation and sinus rhythm, 4) anti-inflammation and anti-allergic therapy to prevent and to treat the arrhythmia.

Abbreviations: AF=atrial fibrillation; SR=sinus rhythm; SAN=sinoatrial node; VQST=vibrantly quiescent stroboscopic tuning; BGD= bridging the gap of dispersion

Credits: Petras Stirbys MD, PhD



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