High resolution signal averaged electrocardiography may improve diagnosis of atrial fibrillation and reduce stroke

Pathophysiology of Atrial Fibrillation (AF) is multifactorial, by linking elec- trical alterations with neurohormonal factors and structural changes of the left atrium (LA). Also pulmonary veins have a central role in the pathophysiology of AF, through re- entry circuits that, spreading to the atria, may generate a “chaotic” electrical activation. Structural alterations, such as LA enlargement, fibrosis and adipose tissue deposition, may further promote a disorganized electrical conduction, by creating anatomical conduction blocks, which generate and sustain the development of AF.