PMC:6019327 / 28100-29192 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/6019327","sourcedb":"PMC","sourceid":"6019327","source_url":"https://www.ncbi.nlm.nih.gov/pmc/6019327","text":"Nathan and Eliakim first drew attention to the presence of sleeves of cardiac tissue that extend onto the PVs (Figure 1E).70 Myocardial muscle fibers extend from the LA into all the PVs for 1–3 cm; the thickness of the muscular sleeve is highest at the proximal ends (1–1.5 mm), and then gradually decreases distally.16,64,71 The orientation of the major atrial muscular bundles (e.g., Bachmann’s bundle or Crista terminalis) has been recognized from anatomical dissections, with mostly circular bundles around the ostia of the PVs, AV valves, and LAA.72 Studies have described how premature firing from the PVs can initiate AF by interacting with tissue mechanisms, using diffusion tensor imaging (at present, in vitro).73,74 These findings have been reproduced by cardiac magnetic resonance imaging (MRI), highlighting the very variable individual pattern of fiber orientation.75 Future in vivo implementation (in addition to identification of fibrosis), combined with simultaneous mapping techniques, could allow individual tailoring of interruption of potential reentrant 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