The variant 352C>T (p.Arg118Cys) in exon 2 of the GLA gene wasinitially described to be pathogenic by Spada et al.34 According to Ferreira et al.,35 the moderated enzymatic deficiencyrelated to p.Arg118Cys may not be sufficient to cause major complications of FD,suggesting low pathogenicity.35This mutation was found in two unrelated patients (patients 3 and 4), both with LVH.Patient 3 also showed first-degree atrioventricular block and paroxysmal atrialfibrillation on ECG, as well as proteinuria. This evidence concerns the gene GLA and atrial fibrillation.