ABSTRACT

Atrial fi brillation (AF) is the most common cardiac arrhythmia. Its incidence rate and prevalence constantly rises with age. AF not only impairs quality of life, but also increases mortality due to its attributed stroke risk and related heart failure. AF is a major contributor to apoplectic stroke at all ages because of thrombus formation especially in the left atrial appendage with consecutive thromboembolism to brain arteries. Th erefore, AF-related stroke contributes to about 30% of all strokes in elderly patients. Recent studies showed the importance of prothrombotic endocardial changes for the development of atrial thrombi. Th e initiating mechanism is the increased expression of adhesion molecules, which allows the endocardial recruitment of infl ammatory cells and leukocyte-platelet conjugates to the atrial endothelium. Th is chapter summarizes AF-related cellular and molecular changes, focussing on the role that adhesion molecule expression

plays in the context of AF and thrombus formation. It further discusses underlying mechanisms for altered adhesion molecule expression and possible treatment options that may infl uence these mechanisms.