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The number of arrhythmogenic foci increases in persistent AF compared to paroxysmal AF but decreases after 12 months of persistence, leaving their role in AF maintenance unclear.
I n this issue of the Circulation: Arrhythmia and Electro- physiology, Kurotobi et al 1 determined the number of arrhythmogenic foci in atria provocable with isoproterenol infusion in patients with paroxysmal, persistent, and permanent atrial fibrillation (AF). The results show that persistent AF has more foci than paroxysmal AF. However, when AF persists for 12 months, the number of foci were reduced. The authors suggest that the increased number of foci probably is involved in the development of persistent AF. However, because this association is not observed for AF that persists for 12 months, the importance of these foci in AF maintenance remains unclear.
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Chen et al. (2010) studied this question.
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