What is the effect of longer sustained AF on the heart's remodeling process?

Longer sustained atrial fibrillation (AF) significantly impacts the cardiac remodeling process, primarily by increasing the remodeling that occurs in the heart's atria and ventricles. During episodes of AF, the irregular and often rapid beating can lead to alterations in the structure and function of the heart tissue. This is known as electrical and structural remodeling.

As AF persists, the increased atrial pressure and volume overload contribute to changes in the myocardial tissue, such as fibrosis, hypertrophy, and dilation of the atrial chambers. These changes can cause the heart to become less efficient at pumping blood, contribute to worsening heart function, and create a vicious cycle where the presence of AF leads to further structural changes, which in turn can sustain the AF.

The process of remodeling is particularly concerning as it may lead to a worsening of heart failure and increase the risk of stroke and other complications. Thus, the effect of longer sustained AF is to increase the remodeling process, which highlights the importance of managing the condition to potentially reverse or mitigate these changes.