Abstract
Atrial fibrillation is the most common cardiac arrhythmia mainly caused by valvular, ischemic, hypertensive, and myopathic heart disease. Atrial fibrillation can occur in families suggesting a genetic background especially in younger subjects. Additionally recent studies have identified common genetic variants to be associated with atrial fibrillation in the general population. This cardiac arrhythmia has important public health implications because of its main complications: congestive heart failure and ischemic stroke. Since atrial fibrillation can result in ischemic stroke, one might assume that genetic determinants of this cardiac arrhythmia are also implicated in cerebrovascular disease. Ischemic stroke is a multifactorial, complex disease where multiple environmental and genetic factors interact. Whether genetic variants associated with a risk factor for ischemic stroke also increase the risk of a particular vascular endpoint still needs to be confirmed in many cases. Here we review the current knowledge on the genetic background of atrial fibrillation and the consequences for cerebrovascular disease.
Highlights
Of all cardiac arrhythmias, atrial fibrillation (AF) is the most common, affecting approximately 1-2% of the population [1]
Since atrial fibrillation can result in ischemic stroke, one might assume that genetic determinants of this cardiac arrhythmia are implicated in cerebrovascular disease
Whether genetic variants associated with a risk factor for ischemic stroke increase the risk of a particular vascular endpoint still needs to be confirmed in many cases
Summary
Atrial fibrillation (AF) is the most common, affecting approximately 1-2% of the population [1]. Patients with AF frequently have other cardiovascular and noncardiovascular comorbidities, the most important condition being hypertension [3], which is an important risk factor for the development of AF [4]. In patients with AF, various independent factors raise the risk of stroke such as the presence of hypertension, advancing age and diabetes and the previous occurrence of a stroke or transient ischemic attack (TIA) [5, 6]. Epidemiological studies have identified various risk factors for AF which include age, male sex, hypertension and the presence of structural heart abnormalities. The genetic background of AF in the general population has been studied through association studies (Table 1). Since stroke is a major complication of AF, genetic variants associated with this arrhythmia may be implicated in ischemic cerebrovascular disease. We present an overview of the current knowledge in the monogenic forms and complex genetics of AF and discuss the consequences for ischemic stroke
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