Fibrosis may not be driving AF

[Barny12]

This sounds like it could be important:

Background:

"The current paradigm is that fibrosis promotes electrophysiological disorders and drives atrial fibrillation (AF). In this current study, we investigated the relation between the degree of fibrosis in human atrial tissue samples of controls and patients in various stages of AF and the degree of electrophysiological abnormalities."

Conclusions:

"No differences in the degree of fibrosis were observed in patients from various stages of AF compared to the controls. Moreover, electrophysiological abnormalities did not correlate with any of the fibrosis markers. The findings indicate that fibrosis is not the hallmark of structural remodeling in AF."

mdpi.com/2073-4409/11/3/427

[PlanetaryKim]

Wow! That's very interesting. I have been focusing a lot on fibrosis and strategies for reversing fibrosis.

[nmack in reply to PlanetaryKim]

Hi. I recently had my first and probably only catheter ablation. It went well but they discovered moderate left atrial scarring (LAS), which will likely reduce the success rate of the procedure and preclude any future ablations. I did a little reading and saw some studies on pirfenidone in reducing cardiac scarring/fibrosis. I'm curious to see what you have found. My first follow up is in two weeks so I'm collecting questions now.

Thanks.

.

[CDreamer]

Interesting. Hope this is the start of a broadening of thinking.

[Hidden in reply to CDreamer]

Exactly my thoughts the other day. The cardiologists treat the symptoms by applying the protocols, and that'it.

[Maggimunro]

Hi BarnyThanks for that. It looks like a solid study, with reputable authors, however, it was only 115 patients.

Clearly larger studies are needed to confirm or refute these findings.

[KMRobbo]

Very interesting. Not medically trained , but have always wondered why my cryoablation stopped my AFIB when it blocked signals from outside my heart, not within it?

I assumed that was because there were different causes of AFib and atrial remodelling was something physical caused by it ( excessive fibrillation - Afib begets AFib) , or by something else ( eg surgery/ heart attack) causing the fibrosis changes.

If this study is correct then it would appear this is not the case.

I dont think this says there is not any "remodelling " just that the electrical changes are not related to the physical fibrosis.

Or am I misunderstanding owing to my medical ignorance?

[jimlad2]

Yep . . My understanding is the same as yours, per your penultimate sentence . .