Atrial Fibrillation, Heart Failure, and the Autonomic Nervous System

In 1628, William Harvey described the importance of the auricle during the motion of the heart: “First the auricle contracts, and this force the abundant blood it contains as the cistern and reservoir of the veins, into the ventricle. This being filled, the heart raises itself, makes its fibers tense, contracts, and beats. By this beat it at once ejects into the arteries the blood received from the auricle.” Three centuries later, Gesell described the association between atrial fibrillation and a drop in the arterial pressure, further describing that the blood pressure effects were reversed with restoration of sinus rhythm [1] (Fig. 2.1).