{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390282680223751168.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.4020/jhrs.23.4"}},{"identifier":{"@type":"URI","@value":"https://onlinelibrary.wiley.com/doi/full/10.4020/jhrs.23.4"}},{"identifier":{"@type":"DOI","@value":"10.1016/s1880-4276(07)80010-x"}},{"identifier":{"@type":"NAID","@value":"10019921608"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2007236884"}}],"dc:title":[{"@language":"en","@value":"Atrial Fibrillation Revisited-With a Special Reference to Primary Prevention-"}],"dc:language":"en","description":[{"notation":[{"@value":"Atrial fibrillation (AF) is common arrhythmia and results in a rapid and irregular rhythm. Patients with this arrhythmia may be asymptomatic but AF often causes palpitation or chest discomfort especially when it develops in its paroxysmal form and patients might develop fatigue easily or reduced working capacity. Because of a loss of atrial contribution to ventricular filling, AF results in a decrease of cardiac output by 15% at rest and up to 30% upon exercise. Long-standing tachycardia leads to cardiac dysfunction known as tachycardia-induced cardiomyopathy and AF can be the cause of such cardiomyopahty and results in atrial stunning. The prevalence of AF increases with advanced age: 0.4% in the general population but less than 6% in those >80 years and the elder patients are prone to develop heart failure. Rarely, AF can be fatal in WPW syndrome when rapid ventricular activation occurs via the Kent bundle. In addition to such morbidity, AF is the major cause of stroke and is associated with increased mortality and morbidity. For stroke in patients with AF, several risk factors have been established and in animal model, altered gene expression predisposing to coagulation was confirmed in the endocardium of the paced-atrium. To reduce stroke, efficacy of anticoagulant therapy by Warfarin is well established. Aspirin seems to be inefficacious especially in Japan to prevent stroke due to AF. For AF, antiarrhythmic drugs are prescribed to prevent recurrence but with limited efficacy. The best result in preventing the recurrence of AF is that reported by CTAF using amiodarone, wherein the AF free rate was 60% at the 600th day of therapy. However, the drug might be withdrawn because of side effects and paroxysmal AF progresses eventually to chronic AF over time. Recently, catheter ablation has been established as a new promising therapy to prevent the recurrence of AF but it would be difficult to apply catheter ablation to every patient because of the large number of patients. For these reasons, we have to seek other possibilities and the prevention of the occurrence of AF in the general population is very important. We hereby, review the epidemiology and the underlying diseases of AF from the point of view of primary prevention of AF."}]}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410282680223751169","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Furushima Hiroshi"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiology, Hemotology and Endocrinology, Niigata University Graduate School of Medical and Dental Science"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282680223751170","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Aizawa Yoshifusa"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiology, Hemotology and Endocrinology, Niigata University Graduate School of Medical and Dental Science"}]},{"@id":"https://cir.nii.ac.jp/crid/1410282680223751168","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Watanabe Hiroshi"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Division of Cardiology, Hemotology and Endocrinology, Niigata University Graduate School of Medical and Dental Science"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"18804276"},{"@type":"EISSN","@value":"18832148"},{"@type":"NCID","@value":"AA12059301"}],"prism:publicationName":[{"@language":"en","@value":"Journal of Arrhythmia"},{"@language":"en","@value":"J Arrhythmia"}],"dc:publisher":[{"@language":"en","@value":"Japanese Heart Rhythm Society"},{"@language":"ja","@value":"一般社団法人日本不整脈心電学会"}],"prism:publicationDate":"2007","prism:volume":"23","prism:number":"1","prism:startingPage":"4","prism:endingPage":"11"},"reviewed":"false","dcterms:accessRights":"http://purl.org/coar/access_right/c_abf2","url":[{"@id":"https://onlinelibrary.wiley.com/doi/full/10.4020/jhrs.23.4"},{"@id":"https://search.jamas.or.jp/link/ui/2007236884"}],"availableAt":"2007","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=Cardiology%20and%20Cardiovascular%20Medicine","dc:title":"Cardiology and Cardiovascular Medicine"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360011144045346432","@type":"Article","relationType":["references","cites"],"jpcoar:relatedTitle":[{"@value":"Angiotensin II receptor blockade reduces new-onset atrial fibrillation and subsequent stroke compared to atenolol"}]},{"@id":"https://cir.nii.ac.jp/crid/1360011144046399360","@type":"Article","relationType":["references","cites"],"jpcoar:relatedTitle":[{"@value":"Obesity and Atrial Fibrillation"}]},{"@id":"https://cir.nii.ac.jp/crid/1360011144223538816","@type":"Article","relationType":["references","cites"],"jpcoar:relatedTitle":[{"@value":"Enalapril Decreases the Incidence of Atrial Fibrillation in Patients With Left Ventricular Dysfunction"}]},{"@id":"https://cir.nii.ac.jp/crid/1360011145347023616","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Impaired Myofibrillar Energetics and Oxidative Injury During Human Atrial 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inhibition compared with conventional therapy on cardiovascular morbidity and mortality in hypertension: the Captopril Prevention Project (CAPPP) randomised trial"}]},{"@id":"https://cir.nii.ac.jp/crid/1360292621276212480","@type":"Article","relationType":["references","cites"],"jpcoar:relatedTitle":[{"@value":"Relation between aging and circadian variation of paroxysmal atrial fibrillation"}]},{"@id":"https://cir.nii.ac.jp/crid/1360574094055636736","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Diabetes mellitus is a strong, independent risk for atrial fibrillation and flutter in addition to other cardiovascular disease"}]},{"@id":"https://cir.nii.ac.jp/crid/1360574094316750336","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Effects of angiotensin II type 1 receptor antagonist on electrical and structural remodeling in atrial 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