Hypothesis Generation for a Possible Mechanism of Transmural Reentry Following a Histological Appraisal of Postmortem Atria

The relationship between atrial fibrillation (AF) and atrial anatomy is well recognized and myocardial fibre orientation is known to influence conduction velocity. The precise mechanism of AF perpetuation remains elusive. The prevailing but contrasting hypotheses are re-entrant mechanisms and focal mechanisms. Support for such a unifying mechanism could be provided by finding an anatomical substrate to support epicardial to endocardial connections.