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By Masayasu Hiraoka, International Congress on Electrocardiol

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Understanding the molecular mechanisms is 24 mandatory for understanding the clinical pathophysiology and treatment of atrial fibrillation. I Types of recurrences after cardiwersion I LONG-TERM EFFICACY OF ANTIARRHYTHMIC DRUG THERAPY AND ITS INFLUENCE TO THE PROGNOSIS IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION KEN OKUMURA Second Department of Internal Medicine, Hirosaki University School of Medicine, Japan We examined the long-term efficacy of serial antiarrhythmic drug therapy (AAT) in 290 patients with paroxysmal AF (mean age, 69 years), and studied the relationship between the response to AAT and long-term prognosis of the patients.

The idea that the PVs are capable of spontaneous activity is not new, because, in 1976, Brunton and Fayrer [4] observed spontaneous and independent pulsations of the PVs of rabbits and cats. 2. Myocardial Sleeve of PVs The cardiac muscle extends from the LA into the four PVs to form “myocardial sleeve” and conducts electrical impulses (Fig. 1). This structure is the origin of focal activity in the PVs [ 5 ] . Figure 1. Myocardial sleeve of rabbit right superior pulmonary vein (RS-PV). LA, left atrium.

When molecular biology techniques matured to the point of making possible the identification of disease-causing genes and disease-causing mutations what became essential was the availability of numerous and well worked out clinical pedigrees providing clear separation between “affected” and “non affected” individuals. This is what the Registry was able to provide and where it played a decisive role in sharing with molecular biologists the ideal material for their analysis. In 1979 we could not fathom the explosion of knowledge that would have followed and the now clear evidence that LQTS represents indeed a paradigm for the understanding of sudden cardiac death in more common cardiac diseases.

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