Another mechanism of atrial fibrillation initiation?

Non‐pulmonary vein foci triggering atrial fibrillation: What is the underlying mechanism of “foci”?

“…AF initiation without preceding sinus impulse was not observed, although the length of the sinus arrest after AF termination varied (Figure 1). Considering that sinus impulse itself could trigger AF in the presence of an arrhythmogenic substrate in the PV or right atrial appendage, 1 preceding sinus impulse might be associated with AF initiation in this case as well.…”