Identifies a frameshift mutation in the atrial natriuretic peptide gene as a cause of familial atrial fibrillation, implicating the ANP-cGMP pathway in cardiac electrical instability.
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No immediate change to AF management; leaves open ANP-cGMP pathway as a target in familial cases.
Atrial fibrillation is a common arrhythmia that is hereditary in a small subgroup of patients. In a family with 11 clinically affected members, we mapped an atrial fibrillation locus to chromosome 1p36-p35 and identified a heterozygous frameshift mutation in the gene encoding atrial natriuretic peptide. Circulating chimeric atrial natriuretic peptide (ANP) was detected in high concentration in subjects with the mutation, and shortened atrial action potentials were seen in an isolated heart model, creating a possible substrate for atrial fibrillation. This report implicates perturbation of the atrial natriuretic peptide-cyclic guanosine monophosphate (cGMP) pathway in cardiac electrical instability.
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Hodgson‐Zingman et al. (2008) studied this question.
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