Hello,
I was delighted to find this forum when I was first diagnosed with LAF nine years ago; though, I confess to having followed it less since my subsequent ablation four years ago.
So, please excuse me if I have missed a discussion of it, but I just wanted to be sure that interested members were aware of this October 2016 University of Oxford research paper by Wijesurendra et al: [
circ.ahajournals.org].
At the very least, speaking as someone who is now encountering fairly frequent recurrences of AF after a long spell AF-free, the upshot of the research underlines the need after an ablation to continue to adhere to measures to ameliorate effects of the 'underlying cardiomyopathy'.
I was 50 at first (incidental) diagnosis and comparatively asymptomatic, in terms of being conscious of having lapsed into permanent AF (it took over six months to get around to cardioverting me), but, like many, I can, in retrospect, identify likely, brief episodes much earlier.
My own medical history was, fortunately, remarkable only for early X-Ray exposure, a mouthful of mercury fillings by age 18 and, perhaps as a result, Gilbert's syndrome.
I should say that the radiation exposure arose because my mother (and her sister) worked in radiology in a hospital, well before I was born, with a machine later found to have been discharging far higher doses of radiation than it should. Both my mother and aunt died of cancer comparatively young.
So, I'm interested in the possible impact of ionising and non-ionising radiation on cardiomyopathy, as well as that of mercury toxicity, or (reversing the possible causation) genetic deficiencies in liver metabolism, and mitochondrial dysfunction.
It does seem to me that the consequences of what amounted to a state-sponsored programme to implant the most toxic element (bar the radioactive ones) in childrens' teeth in the UK during the 1960s-1970s seems to have gone surprisingly unremarked (outside these forums, perhaps!), but, given what we know of mercury toxicity, probably explains a lot.
I have been a regular runner - but far from an athlete - just enough to have been routinely wasting critical electrolytes, like magnesium (I was diagnosed while working in the UAE).
While, arguably, it doesn't necessarily help much to ascribe LAF to an "adverse cardiometabolic phenotype", the paper's investigation of left ventricular myocardial energetics is original and points the way to an appropriate focus on 'upstream' problems of cardiac energy metabolism in atrial tissue as the elusive 'substrate' for LAF.
That at least is something to go on when one is contemplating the wisdom of an ablation 'redo', as I am.
