Author + information
- Received August 12, 2019
- Revision received October 9, 2019
- Accepted November 5, 2019
- Published online January 13, 2020.
- Felipe Bisbal, MD, PhDa,b,c,∗ (, )@bisbal_EP,
- Adrian Baranchuk, MDd@adribaran,
- Eugene Braunwald, MDe,
- Antoni Bayés de Luna, MD, PhDc,f and
- Antoni Bayés-Genís, MD, PhDa,b,c
- aHeart Institute (iCor), University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
- bCIBERCV, Instituto de Salud Carlos III, Madrid, Spain
- cDepartment of Medicine, Universitat Autònoma Barcelona, Barcelona, Spain
- dDepartment of Medicine, Division of Cardiology, Heart Rhythm Service, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada
- eCardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- fInstitut Català Ciències Cardiovasculars, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- ↵∗Address for correspondence:
Dr. Felipe Bisbal, Heart Institute - Hospital Universitari Germans Trias i Pujol, Carretera Canyet s/n, 08916 Badalona, Barcelona, Spain.
• Atrial dysfunction is often neglected.
• We propose atrial failure as a clinically relevant entity.
• The concept of atrial failure may foster research leading to a better understanding of atrial dysfunction.
Atrial dysfunction has been widely considered a marker or consequence of other cardiac conditions rather than the cause itself. Here, we propose the term atrial failure as a clinically relevant entity, defined as any atrial dysfunction causing impaired heart performance, symptoms, and worsening quality of life or life expectancy. Aspects of the etiology, mechanisms, and consequences of atrial failure are discussed. Recent advances in cardiac electrophysiology and imaging have improved our understanding of the highly complex atrial anatomy and function, underlying the paramount importance of the atria in optimal heart performance. It is time to reappraise the concept of the failing atrium as a primary cause or aggravating factor of the symptoms in many of our patients. The concept of atrial failure may foster basic and translational research to gain a better understanding of how to identify and manage atrial dysfunction.
This work was supported by Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, Spain (PI18/01227), CIBER Cardiovascular (CB16/11/00403); and La MARATO - TV3 (ID 201527). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 12, 2019.
- Revision received October 9, 2019.
- Accepted November 5, 2019.
- 2020 American College of Cardiology Foundation
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