Subclinical Atherosclerosis and Risk of Atrial Fibrillation

Abstract

Myocardial infarction is a strong predictor of atrial fibrillation, especially in men.¹ Myocardial damage, often in association with heart failure, contributes to the onset of atrial fibrillation in subjects with myocardial infarction. It is not known, however, whether the presence of coronary atherosclerosis without manifest myocardial infarction also causes atrial fibrillation. At a subclinical level, atherosclerotic vascular disease may cause some damage to myocardial tissue by gradually reducing the blood supply to the atrial tissues because of ischemia/infarction, causing premature apoptosis of myocytes, fibrous tissue replacement, and subsequent facilitation of reentry processes.² The role of atherosclerosis in the development of atrial fibrillation is supported by results of studies in which atrial tissues were histologically investigated.^3-5