Short-term progress of patients with self-limited first episode atrial fibrillation

Clear guidelines are lacking for the management of the clinical pattern of first-episode type atrial fibrillation (AF). We retrospectively analysed the clinical evolution of patients with self-limited first episode AF identified from among from 200 patients who had been hospitalised in our cardiology ward with AF. Of the 200 patients, 33 (16.5%) were self-limited first episode. Over a mean follow-up of 19.5+/-12.5 months (53.6 patient-years), 7 patients (21%) had recurrence of arrhythmia and 4 patients (12%) had a thromboembolic episode (7.4 episodes/100 patient-years of follow-up). These results indicate that the profile of thromboembolic risk, and not that of clinical profile presentation of AF, should be the criteria by which to judge the indication for anti-coagulant treatment.