Abstract
To the Editor: We read with interest the recent article by Nanthakumar and colleagues describing electrophysiological findings in 9 adolescents with atrial fibrillation (AF) and structurally normal hearts who failed to respond to antiarrhythmic therapy.1 The authors reported that the electrophysiological substrate of AF was represented by foci in the pulmonary veins, crista terminalis, or left atrium, mainly inducing focal supraventricular tachycardias. Radiofrequency ablation of these foci was effective in eliminating recurrent AF in 7 of 9 patients. Nevertheless, in treating their patients, the authors failed to consider atrial myocarditis as a possible cause of lone AF. Through the histological analysis of biventricular and atrial biopsy samples, we reported a high prevalence …
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