EHRA/HRS/APHRS/SOLAECE

Expert Consensus on

Atrial Cardiomyopathies:

Definition, Characterization and Clinical Implication

Participating Members

European Heart Rhythm Association (EHRA) Professor Andreas Goette Germany Professor Jose Angel Cabrera Spain Professor Domenico Corradi Italy Professor Dobromir Dobrev Germany Professor Stephane Hatem France Professor Gregory Lip UK Professor Gerhard Hindricks Germany Professor Siew Yen Ho UK

Heart Rhythm Society (HRS) Professor Stanley Nattel Canada Asso.Professor David Van Wagoner USA Professor Sumeet Chugh USA Professor Mario Gonzalez USA Doctor Robert Helm USA Professor Katherine Murray USA Doctor Greg Marcus USA Asso.Professor Joseph Akar USA Professor José Jalife USA Professor Brian Hoit USA

Participating Members

Asia Pacific Heart Rhythm Society (APHRS) Professor Jonathan Kalman Australia Professor Prashanthan Sanders Australia Professor Young Hoon Kim Korea Doctor Shih-Ann Chen Taiwan Doctor Chang-Sheng Ma China Doctor Akihiko Nogami Japan

Participating Members

Sociedad Latino Americana de Estimulación Cardíaca y Electrofisiología (SOLAECE)

Doctor Luis Aguinaga Argentina Professor Guilherme Fenelon Brazil Doctor William Uribe Colombia Doctor Andre d’Avila Brazil

Participating Members

EHRA/HRS/APHRS/SOLAECE

Expert Consensus on

Atrial Cardiomyopathies:

Definition, Characterization and Clinical Implication

Atrial Cardiomyopathies: Anatomical Considerations

Goette A, et al. EUROPACE 2016

Goette A, et al. EUROPACE 2016

Classification of Atrial Cardiomyopathies

(EHRAS Class I-IV)

Collagen

Fibroblasts

Cardiomyocytes

Non-Collagen interstitial deposits

Primarily Cardiomyocyte-dependent (Class I)

Primarily Fibroblast-dependent (Class II)

Mixed Cardiomyocyte-Fibroblast-dependent (Class III)

Primarily Non-Collagen Deposits (Class IV)

- lone AF - genetic diseases - diabetes mellitus .

- aging - cigarette smoking

- CHF - valvular diseases

- isolated atrial amyloidosis - granulomatosis - inflammatory Infiltrates - glycosphingolipids

Goette A, et al. EUROPACE 2016

Classification of Atrial Cardiomyopathies

(EHRAS Class I-IV)

Goette A, et al. EUROPACE 2016

Goette A, et al. EUROPACE 2016

Atrial Cardiomyopathies: Mechanical Atrial Function

Goette A, et al. EUROPACE 2016

Atrial Cardiomyopathies: E/C Coupling

Goette A, et al. EUROPACE 2016

Drug-induced Atrial Cardiomyopathies

Goette A, et al. EUROPACE 2016

CHA2DS2VASc Parameters

Atrial Myocardium Atrial Endothelium

Oxidases NF-κB

Oxidases NF-κB

ROS

ROS Troponin Endothelin-1

Angiotensin II

Natriuretic Peptides

Nitric Oxide

vWF VCAM Selectin PAI-1 MCP-1 ICAM

Proteases Phosphatases

Goette A, et al. EUROPACE 2016

Atrial Cardiomyopathies:

„Thrombogenic Endocardial Remodeling“

EHRA/HRS/APHRS/SOLAECE

Expert Consensus on

Atrial Cardiomyopathies:

Definition, Characterization and Clinical Implication

Goette A, et al. EUROPACE 2016 Heart Rhythm 2016 Journal of Arrhythmia 2016