FOUR QUESTIONS ABOUT ATRIAL FIBRILLATION IN CARDIAC AMYLOIDOSIS. WHY IS THIS ARRHYTHMIA DIFFERENT FROM ALL OTHER ARRHYTHMIAS?

AF is a common arrhythmia in cardiomyopathy, particularly when congestive heart failure is present. The neurohormonal activation in congestive heart failure may trigger fibrotic and other changes in the left atrium and the atrial stretch associated with heart failure may induce further atrial pathology and/ or directly trigger AF (8). By the time that patients with AF develop extensive fibrosis, the arrhythmia has been shown to be associated with a greater difficulty in maintaining sinus rhythm despite attempted ablation procedures.