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Atrial fibrillation (AF) is the most common sustained arrhythmia. Approximately seven million people suffer from AF in Europe, and it is likely that several more millions suffer from ‘silent’, undiagnosed AF.1 w1–w3 Once AF has manifested, it is usually a chronically progressing arrhythmia (figure 1A). The presence of AF, especially of long periods of the arrhythmia, causes pronounced electrical and structural alterations in the atria, thereby perpetuating AF and promoting its recurrence. In addition, chronic underlying comorbidities, a genetic predisposition to AF, and ‘natural’ ageing processes remodel the atria and contribute to the initiation and progression of AF (figure 1B).
Competing interests In compliance with EBAC/EACCME guidelines, all authors participating in Education in Heart have disclosed potential conflicts of interest that might cause a bias in the article. The authors have received honoraria for advice and presentations from several drug and medical device companies involved in management of atrial fibrillation, and received research grants DFG, BMBF, Fondation Leducq, and European Union in addition to research support from industry.
Provenance and peer review Commissioned; not externally peer reviewed.