Flickering of cardiac state before the onset and termination of atrial fibrillation.

Complex dynamical systems can shift abruptly from a stable state to an alternative stable state at a tipping point. Before the critical transition, the system either slows down in its recovery rate or flickers between the basins of attraction of the alternative stable states. Whether the heart critically slows down or flickers before it transitions into and out of paroxysmal atrial fibrillation (PAF) is still an open question.

Butterfly in the Heart: Infective Endocarditis after MitraClip Procedure.

• Endocarditis following the MitraClip procedure is extremely rare. • TEE is vital in diagnosing IE when the results of TTE are inconclusive. • The most common cause of IE after the MitraClip procedure is