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(Circulation. 2007;115:3040-3041.)
© 2007 American Heart Association, Inc.

Editorial

Lone Atrial Fibrillation

Good, Bad, or Ugly?

Lars Frost, MD, PhD

From the Department of Medicine, Silkeborg Hospital and Clinical Institute, Aarhus University Hospital, Silkeborg, Denmark.

Correspondence to Lars Frost, MD, PhD, Head of Cardiology, Associate Professor, Department of Medicine, Silkeborg Hospital and Clinical Institute, Aarhus University Hospital, Falkevej 1–3, DK-8600 Silkeborg, Denmark. E-mail malfr@sc.aaa.dk

Key Words: Editorials • electrophysiology • epidemiology • fibrillation • genes

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The term lone auricular fibrillation was introduced by Evans and Swann¹ in 1953. Lone atrial fibrillation has not been defined with any consistency, mainly because of the introduction of echocardiography and changes in criteria for hypertension. Currently, lone atrial fibrillation is considered a nosographic entity, only when clinical and echocardiographic evidence of cardiovascular or pulmonary disease has been ruled out. Conditions such as hypertension, diabetes, hyperthyroidism, acute infections, recent cardiothoracic or abdominal surgery, and systemic inflammatory diseases should be excluded also. There is no consensus as to whether atrial fibrillation occurring in patients with sick sinus syndrome should be considered lone atrial fibrillation.

Article p 3050

Cardiologists with strong political influence have suggested that a diagnosis of lone atrial fibrillation should be restricted to patients <60 years of age,² although there is no evidence of any threshold values by age regarding the risk of stroke in patients with atrial fibrillation³—or in any other medical condition for that matter.⁴

Several other problems are associated with "threshold decision making." Should we consider atrial fibrillation caused by overweight or obesity^5,6 as lone atrial fibrillation? How little alcohol has to be consumed^7–9 before we call the patient a "lone atrial fibrillator"? How much exercise must be performed before we think atrial fibrillation may be caused by excessive sporting activities¹⁰ and therefore should not be classified as true lone atrial fibrillation? And what about those individuals who experience exercise-induced atrial fibrillation¹¹?

Perhaps we should stop using terms such as idiopathic or lone because . . . [Full Text of this Article]

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