Abstract
A full understanding of the underlying mechanisms of human atrial fibrillation (AF) remains an ongoing challenge despite decades of basic and clinical research. Many of the insights into the complex dynamics of wave propagation have come from detailed investigation of animal models of AF. Both mitral regurgitation and congestive heart failure produce structural remodeling and increased fibrosis resulting in AF. 1 Li D. Fareh S. Leung T.K. Nattel S. Promotion of atrial fibrillation by heart failure in dogs: atrial remodeling of a different sort. Circulation. 1999; 100: 87-95 Crossref PubMed Scopus (1127) Google Scholar , 2 Everett 4th, T.H. Wilson E.E. Verheule S. Guerra J.M. Foreman S. Olgin J.E. Structural atrial remodeling alters the substrate and spatiotemporal organization of atrial fibrillation: a comparison in canine models of structural and electrical atrial remodeling. Am J Physiol Heart Circ Physiol. 2006; 291: H2911-H2923 Crossref PubMed Scopus (95) Google Scholar Pacing-induced AF and vagally mediated AF models are characterized by spatially heterogeneous shortening and loss of rate adaptation of atrial refractoriness (atrial effective refractory period [AERP]), so-called electrical remodeling without obvious structural abnormalities of conduction. 3 Wijffels M.C. Kirchhof C.J. Dorland R. Allessie M.A. Atrial fibrillation begets atrial fibrillation A study in awake chronically instrumented goats. Circulation. 1995; 92: 1954-1968 Crossref PubMed Scopus (2879) Google Scholar , 4 Ausma J. Wijffels M. Thone F. Wouters L. Allessie M. Borgers M. Structural changes of atrial myocardium due to sustained atrial fibrillation in the goat. Circulation. 1997; 96: 3157-3163 Crossref PubMed Scopus (652) Google Scholar , 5 Morillo C.A. Klein G.J. Jones D.L. Guiraudon C.M. Chronic rapid atrial pacing Structural, functional, and electrophysiological characteristics of a new model of sustained atrial fibrillation. Circulation. 1995; 91: 1588-1595 Crossref PubMed Scopus (945) Google Scholar , 6 Nattel S. Shiroshita-Takeshita A. Brundel B.J. Rivard L. Mechanisms of atrial fibrillation: lessons from animal models. Prog Cardiovasc Dis. 2005; 48: 9-28 Abstract Full Text Full Text PDF PubMed Scopus (170) Google Scholar Correlation of specific animal models to human clinical syndromes has been challenging. However, in general terms, the latter models are produced without structural heart disease, so they most mimic idiopathic paroxysmal human AF.
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