“…The decrease in I Ca(L) seen early in response to rapid atrial stimulation continues in response to repeated episodes of AF (Yue et al, 1997 ; Van Wagoner et al, 1999 ; Workman et al, 2001 ; Yagi et al, 2002 ; Christ et al, 2004 ; Lenaerts et al, 2009 ; Voigt et al, 2012 ), potentially caused by lower levels of mRNA for the alpha subunit (Brundel et al, 1999 , 2001 ; Lai et al, 1999 ; Van Gelder et al, 1999 ; van der Velden et al, 2000b ; Gaborit et al, 2005 ), reduced LTCC protein expression (Brundel et al, 1999 , 2001 ; Lenaerts et al, 2009 ), a shift in single channel gating (Lenaerts et al, 2009 ) and potentially a reduction in single channel open probability due to reduced phosphorylation (Christ et al, 2004 ). The time course over which these changes occur has been variably reported as between 2 and 6 months (Van Gelder et al, 1999 ; van der Velden et al, 2000b ), which may reflect differences in AF burden between studies. Studies investigating LTCCs during the progression of AF report decreased expression in persistent AF but not in paroxysmal AF suggesting I Ca(L) might decrease over the time course of the disease (Brundel et al, 1999 ; Van Gelder et al, 1999 ).…”