Why the study?
The precise mechanism of AF perpetuation remains elusive, and identifying an anatomical substrate supporting epicardial-to-endocardial connections could help unify re-entrant and focal hypotheses.
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Population
Postmortem atria
Design
Histological appraisal
Answers are grounded in this paper and cite their sources.
May support unifying AF mechanisms via epicardial-endocardial connections; leaves open prospective validation in clinical mapping studies.
The relationship between atrial fibrillation (AF) and atrial anatomy is well recognized and myocardial fibre orientation is known to influence conduction velocity. The precise mechanism of AF perpetuation remains elusive. The prevailing but contrasting hypotheses are re-entrant mechanisms and focal mechanisms. Support for such a unifying mechanism could be provided by finding an anatomical substrate to support epicardial to endocardial connections.
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Ciara et al. (2020) studied this question.
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