Mechanisms underlying atrial myopathy and atrial fibrillation

Atrial fibrillation is the most common cardiac arrhythmia worldwide and prevalence is expected to continue rising at an exponential rate with an aging population and increasing rates of obesity and diabetes globally. Atrial fibrillation is associated with an increased incidence of stroke and HF. Once atrial fibrillation is present, it can be very difficult to treat. While atrial fibrillation ablation is successful in a number of patients, approximately one-third of patients will experience recurrence of atrial fibrillation, and this can be even higher in patients with persistent atrial fibrillation. A key feature of atrial fibrillation is atrial myopathy which can include atrial enlargement/dilatation, fibrosis, metabolic and contractile dysfunction. Pathological atrial myopathy predisposes to atrial fibrillation, heart failure and stroke. There is a clinical need to identify pathological atrial myopathy and atrial fibrillation risk earlier to improve outcomes. By understanding mechanisms and prevention/treatment strategies that prevent/attenuate/reverse atrial myopathy and atrial fibrillation, we will be better positioned to tackle this very challenging arrhythmia.

We welcome basic/discovery, preclinical and clinical original articles, meta-analysis and reviews, covering, but not limited to, the following topics:

• Molecular mechanisms underlying atrial enlargement, fibrosis, metabolism, function, and atrial thrombosis.
• Impact of obesity, diabetes and aging on atrial biology and susceptibility to atrial fibrillation.
• Preclinical studies assessing novel therapeutic strategies to prevent/treat atrial pathology and atrial fibrillation.
• Clinical studies evaluating catheter ablation or new therapeutic approaches.
• Assessment and identification of new/improved blood markers, imaging measures (echocardiography, PET, MRI), risk prediction models, and digital technology/artificial intelligence methods for identifying atrial myopathy, atrial thrombosis and/or atrial fibrillation earlier.  
• Associations and links between atrial myopathy and atrial fibrillation with heart failure, stroke, neurological decline and pathology in other organs.
• Assessment of exercise/physical activity and/or other lifestyle factors on prevention or attenuation of atrial myopathy and atrial fibrillation.
• Studies characterizing/understanding mechanisms underlying atrial myopathy and atrial fibrillation in endurance athletes.

We encourage the submission of research which has examined these topics in both males and females.