Therapeutic implications of atrial fibrillation mechanisms: can mechanistic insights be used to improve AF management?

Atrial fibrillation (AF) is a very common clinical problem, and presently available treatment options are suboptimal. A tremendous amount has been learned over the past 10 years about the atrial substrates that support sustained AF at the tissue, ionic and molecular levels. This understanding of the fundamental mechanisms underlying AF has opened up a variety of new, rationally-based therapeutic approaches. The present paper reviews what is known about the mechanistic substrates that lead to AF and discusses the potential therapeutic consequences.