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Atrial fibrillation (AF) is a supraventricular tachyarrhythmia. It is the most common acute or chronic cardiac disorder seen in clinical practice [1]. Episodes of AF can be intermittent and the arrhythmia itself can be a chronic, life-long condition that is very difficult to manage effectively by clinical practitioners. There have been an increasing number of reports documenting the potential involvement of a number of microorganisms in the etiology of cardiovascular disease [2-4]. One specific chronic infection that is a noncardiac factor controversially reported to be associated with heart disease is Helicobacter pylori, a Gram-negative bacterium more commonly known for infecting the gastric mucosa and causing gastritis. This article gives a brief insight into AF and specifically explores recent evidence suggesting that AF may be caused by H. pylori infection, due to the latter initiating a systemic inflammatory response that contributes to the structural changes that have been observed in the atria of AF patients. Should a causal link between H. pylori infection and AF be proven, the therapeutic opportunities are considerable, given the relatively cost-effective options for treating this infection as well as the reduction in the burden of AF-caused illnesses that will occur.
Symptoms & clinical features of AF
AF is a complex cardiac arrhythmia that is caused by chaotic electrical impulses within the upper chambers of the heart that give rise to a rapid and highly irregular heartbeat. The heart pumps poorly under these conditions of accelerated cardiac activity, which leads to the many clinical symptoms experienced by those with AF. Symptoms include palpitations, fatigue, chest pain, syncope and dyspnea. In addition, the arrhythmia can be associated with hemodynamic dysfunction, tachycardia-induced cardiomyo-pathy and systemic embolism [5,6]. There are also some patients who can be asymptomatic [5].
Burden of illness associated with AF
Major social and economic costs due to the significant morbidity and mortality, as well as associated medical costs, are incurred from patients with AF (Box 1) [7]. The mortality rate of patients with AF is approximately double that of patients in normal sinus rhythm and is linked with the severity of underlying heart disease [6]. The prevalence of AF is estimated to be 0.4-1% of the general population, with an increasing prevalence with age [6]. Projections on the US population...