European Journal of Molecular & Clinical Medicine

Atrial fibrillation (AF) is the most common arrhythmia inclinical practice. Several
conventional and novel predictorsof AF development and progression (from paroxysmalto
persistent and permanent types) have been reported.The most important predictor of AF
progression ispossibly the arrhythmia itself. The electrical, mechanicaland structural
remodeling determines the perpetuationof AF and the progression from paroxysmal to
persistentand permanent forms. Common clinical scores such asthe hypertension, age ≥ 75
years, transient ischemicattack or stroke, chronic obstructive pulmonary disease,and heart
failure and the congestive heart failure,hypertension, age ≥ 75 years, diabetes mellitus,
stroke/transient ischemic attack, vascular disease, age 65-74years, sex category scores as well
as biomarkers relatedto inflammation may also add important information onthis topic. There
is now increasing evidence that even inpatients with so-called lone or idiopathic AF, the
arrhythmiais the manifestation of a structural atrial disease whichhas recently been defined
and described as fibrotic atrialcardiomyopathy. Fibrosis results from a broad rangeof factors
related to AF inducing pathologies such ascell stretch, neurohumoral activation, and
oxidativestress. The extent of fibrosis as detected either by lategadolinium enhancement -
magnetic resonance imaging
or electroanatomic voltage mapping may guide thetherapeutic approach based on the
arrhythmia substrate.The knowledge of these risk factors may not only delayarrhythmia
progression, but also reduce the arrhythmiaburden in patients with first detected AF. The
presentreview highlights on the conventional and novel risk