Abstract
Abstract Atrial fibrillation (AF) is the most common cardiac arrhythmia. Many studies have investigated the cause for the development of AF in the left ventricle dysfunction. Recently the hypothesis was proposed that atrial fibrillation is a protective physiological mechanism, based on the termination of atrial mechanical systole. This reduces the enddiastolic pressure in the left ventricle by excluding the component of systolic left atrial pressure from the total enddiastolic pressure and, respectively, in the system of the pulmonary veins and alveolar capillaries in situation of the left ventricle dysfunction, and thus reduces the likelihood for development of pulmonary congestion. First of all this hypothesis explains relationship between left ventricle dysfunction and AF. The hypothesis helps to build algorithms of the development AF in the cases of the left ventricle dysfunction in the various diseases and conditions.
Highlights
Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice and is most often associated with left ventricle (LV) dysfunction/heart failure (HF)
At the end of the LV diastole, while the MV is still open, the end-diastolic pressure (EDP) is immediately transmitted and equalized through the communicating system of the LV, left atrial (LA), pulmonary veins (PV), and alveolar capillaries (AC), as there are no obstacles to spread of the EDP wave
It is logical to assume that the termination of both left and right side mechanical atrial systole, as a result of the development of the AF, creates more favorable, more optimal hydrodynamic conditions for the heart in a status of LV dysfunction, which is a manifestation of many cardiovascular diseases
Summary
Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice and is most often associated with left ventricle (LV) dysfunction/heart failure (HF). Pulmonary edema is usually present when PWP increases to 20 mm Hg. It is logical to assume that the termination of both left and right side mechanical atrial systole, as a result of the development of the AF, creates more favorable, more optimal hydrodynamic conditions for the heart in a status of LV dysfunction, which is a manifestation of many cardiovascular diseases. The main purpose of AF is to eliminate the mechanical systole of the LA in order to reduce the intercommunicated pressure in the system (LA-PV-AC), and of the RA with the effect of reducing preload, and prevent pulmonary congestion and edema in the conditions and the diseases which cause to increase this pressure By means of this hypothesis it is possible to present an algorithm of relationships between AF and LV dysfunction (Figures 1-5).
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