Cardiac amyloidosis presenting with paroxysmal atrial fibrillation.
### Learning Point for Clinicians

We strongly recommend that when patients present with recurrent atrial fibrillation, despite medical and ablation therapy, low voltage on electrocardiogram and left ventricular hypertrophy on echocardiogram, restrictive cardiomyopathy (RCM) should be included in the differential diagnosis, especially amylodosis, which is known as the most common cause of RCM in USA.

Amyloidosis is a rare disease with an incidence of approximately 6–10 cases per million person years.1 It is defined as tissue deposition of fibrils consisting of different types and weight of normal serum proteins’ subunits. Amyloidosis disease can involve different organs depending on the subtype. Amyloidosis frequently …