Spontaneous Initiation of Atrial Fibrillation by Ectopic Beats Originating in the Pulmonary Veins

Atrial fibrillation is the most common of all sustained cardiac arrhythmias, with the prevalence increasing with age to up to 5 percent in persons more than 65 years of age, and it is a major cause of stroke. 1 – 3 Experimental studies and human surgical mapping studies have shown that atrial fibrillation is perpetuated by reentrant wavelets propagating in an abnormal atrial-tissue substrate. 4 – 8 Complex approaches have been developed to interrupt wavelets, including extensive surgical or, recently, catheter-mediated atriotomy. 9 – 21 There are, however, no data about the spontaneous initiation of atrial fibrillation. The triggers of atrial fibrillation may be focal targets . . .