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(Circulation Research. 2007;101:853.)
© 2007 American Heart Association, Inc.

Editorials

Left Right Asymmetry, the Pulmonary Vein, and A-Fib

James F. Martin

From the Institute of Biosciences and Technology, Texas A&M System Health Science Center, Houston.

Correspondence to James F. Martin, Institute of Biosciences and Technology, Texas A&M System Health Science Center, 2121 Holcombe Blvd, Houston, TX 77030.

See related article, pages 902–909

Key Words: atrial fibrillation • pulmonary vein • left right asymmetry

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Atrial Fibrillation: General Considerations

 
Atrial fibrillation (AF), a common adult cardiac arrhythmia, involves abnormal atrial contractions. As every medical student is taught, it is easily diagnosed as an irregularly irregular pulse and loss of organized atrial activity on an ECG. Clinical interest in AF is considerable because AF is the most common adult arrhythmia that increases in prevalence with age, with 5% of the over 65 population having AF. Moreover, patients with AF have a significantly increased risk of stroke.¹

Electrical impulses, critical for a coordinated and physiologic heartbeat, are normally initiated in the sinoatrial (SA) node. However, in AF the disorganized atrial activity overrides normal SA node function resulting in irregular conduction of impulses to the ventricles. In the majority of cases, ectopic electrical activity originates in the pulmonary veins.¹

In this issue of Circulation Research, Mommersteeg and colleagues² make a significant advance in our understanding of pulmonary vein development by making a strong connection between AF and embryonic axis determination. Moreover, their work fits nicely with exciting new data from human genetic studies implicating the same genetic pathways in familial AF.³

Mommersteeg and colleagues make a number of fundamental observations regarding pulmonary vein development. Previous work suggested that pulmonary myocardium derives from atrial myocardium.⁴ Using lineage tracing, the authors convincingly rule out this possibility. Moreover, they show other data revealing that pulmonary myocardium is derived from Isl1-positive second heart field and has a distinct origin from the systemic venous circulation.⁵ Together, these findings suggest that the pulmonary vein myocardium forms . . . [Full Text of this Article]

Related Article:

Pitx2c and Nkx2-5 Are Required for the Formation and Identity of the Pulmonary Myocardium

Mathilda T.M. Mommersteeg, Nigel A. Brown, Owen W.J. Prall, Corrie de Gier-de Vries, Richard P. Harvey, Antoon F.M. Moorman, and Vincent M. Christoffels
Circ. Res. 2007 101: 902-909. [Abstract] [Full Text] [PDF]

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