Lone Auricular Fibrillation

Abstract

Mitral stenosis, thyroid toxemia, cardiac infarction, constrictive pericarditis, and hypertension are among the common causes of auricular fibrillation. Occasionally, however, the arrhythmia is discovered fortuitously and subsequent investigation shows that structural heart disease is absent. The condition has been described. variously as benign, idiopathic, arteriosclerotic, functional, and senile fibrillation, fibrillation of unknown origin and fibrillation without heart disease. We have proposed for it the term lone auricularfibrillation. Twenty patients were selected for an analysis of the special features that characterize lone fibrillation. Apart from taking each patient's history and recording the findings of a routine clinical examination, special tests were made when necessary to exclude heart disease of any kind. An electrocardiogram was always taken, not so much to confirm the nature of the arrhythmia as to show the absence of preponderance of either ventricle and of cardiac infarction. Once, the basal metabolic rate was estimated and a radioactive iodine test used to exclude thyroid toxemia. A phonocardiogram was recorded in most of the patients to prove the absence of murmurs and added sounds, especially the mitral snap, even though they had been inaudible. Cardioscopy was carried out in each case to ensure the absence of cardiac enlargement from any source, and particularly to show that mitral valve disease was not the cause of the fibrillation. Incidence. Although this form of arrhythmia is uncommon when compared with that found in mitral stenosis, it is not rare. We have omitted an estimate of its incidence among the other causes of fibrillation because such a figure is unlikely to be a true one since the condition, through absence of symptoms, often remains undiscovered until a medical examination brings it to light. Those who have written on auricular fibrillation without heart disease (

2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

“…11,22,27,28 In some series, however, the observed proportion of lone AF was over 30%. 29,30 These differences may depend on selection bias when recruiting patients seen in clinical practice compared with population-based observations.…”

Hemodynamic effects after reversion from atrial fibrillation to sinus rhythm by precordial shock.

“…Patients with lone or benign fibrillation have a good prognosis (8), but systematic observations on the effects of reversion have not been previously available.…”

“…Seventeen patients had rheumatic heart disease. Six patients had no valvular abnormalities and normal to slightly enlarged hearts and are classified as "benign" fibrillators (8). None of these patients had angina or evidence of old or recent myocardial infarction.…”

Time course of hemodynamic changes and improvement of exercise tolerance after cardioversion of chronic atrial fibrillation unassociated with cardiac valve disease

“…Lone" AF was diagnosed only in the absence of any demonstrabie underlying heart disease. 19 Previous duration of the arrhythmia was determined by careful examination of the patient's medicaJ record, by questioning the patient and by reviewing all previous eleetrocardiograms. A 24- va. ?…”