ATRIAL FIBRILLATION: PATHOPHYSIOLOGY, CLINICAL MANIFESTATIONS, AND MANAGEMENT

Abstract

 Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide and is associated with significant morbidity and mortality. Its prevalence increases with age and the presence of comorbidities such as hypertension, diabetes mellitus, heart failure, and structural heart disease. AF is characterized by rapid, irregular atrial electrical activity that leads to impaired atrial contraction, hemodynamic compromise, and increased risk of thromboembolic events, particularly stroke. The pathophysiology of AF is complex and involves triggers such as ectopic foci, atrial structural remodeling, and electrophysiological changes that promote reentry circuits. Clinical manifestations range from asymptomatic episodes detected incidentally to symptomatic presentations including palpitations, fatigue, dyspnea, and dizziness. Complications of AF, particularly thromboembolism, significantly affect patient prognosis and quality of life. Management of AF requires a multifaceted approach, including rate or rhythm control strategies, anticoagulation to prevent thromboembolic events, and consideration of invasive procedures such as catheter ablation in selected patients. Early recognition, risk stratification, and individualized treatment plans are essential to optimize outcomes.

This review summarizes current understanding of the epidemiology, pathophysiology, clinical manifestations, and management strategies of atrial fibrillation, emphasizing the importance of early detection and comprehensive care to reduce morbidity and improve patient prognosis.