期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 63, 期 17, 页码 1715-1723出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2014.01.023
关键词
idiopathic atrial fibrillation; lone atrial fibrillation; white paper
资金
- Boehringer Ingelheim
- Bristol Myers Squibb/Pfizer
- Sanofi Aventis
- Biotronik
- Boston Scientific/Guidant (Europe)
- Medtronic
- Merck
- St. Jude Medical
- National Institutes of Health [R01HL092577, R01HL104156, 1K24HL105780]
- American Heart Association [13EIA14220013]
- iRhythm
- Biosense Webster
- Boston Scientific
- Netherlands Organization for Scientific Research [016.136.055]
The historical origin of the term lone atrial fibrillation (AF) predates by 60 years our current understanding of the pathophysiology of AF, the multitude of known etiologies for AF, and our ability to image and diagnose heart disease. The term was meant to indicate AF in patients for whom subsequent investigations could not demonstrate heart disease, but for many practitioners has become synonymous with idiopathic AF. As the list of heart diseases has expanded and diagnostic techniques have improved, the prevalence of lone AF has fallen. The legacy of the intervening years is that definitions of lone AF in the literature are inconsistent so that studies of lone AF are not comparable. Guidelines provide a vague definition of lone AF but do not provide direction about how much or what kind of imaging and other testing are necessary to exclude heart disease. There has been an explosion in the understanding of the pathophysiology of AF in the last 20 years in particular. Nevertheless, there are no apparently unique mechanisms for AF in patients categorized as having lone AF. In addition, the term lone AF is not invariably useful in making treatment decisions, and other tools for doing so have been more thoroughly and carefully validated. It is, therefore, recommended that use of the term lone AF be avoided.
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