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Lone atrial fibrillation: does it exist?

D George Wyse1, Isabelle C Van Gelder2, Patrick T Ellinor3

  • 1Libin Cardiovascular Institute of Alberta/University of Calgary, Calgary, Alberta, Canada.

Journal of the American College of Cardiology
|February 18, 2014
PubMed

Insights

The term "lone atrial fibrillation" (AF) is outdated and lacks a clear definition, leading to inconsistent research. Experts recommend abandoning this term for better clarity in diagnosing and treating AF.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • The term "lone atrial fibrillation" (AF) originated when understanding of AF pathophysiology and diagnostic capabilities were limited.
  • Historically, it described AF in patients without identifiable heart disease, but has become conflated with "idiopathic AF."

Purpose of the Study:

  • To critically evaluate the historical context, definition, and clinical utility of the term "lone AF."
  • To recommend a revised approach to AF classification and diagnosis.

Main Methods:

  • Review of historical literature and current guidelines regarding the definition and diagnosis of lone AF.
  • Analysis of the evolution of understanding AF pathophysiology and diagnostic technologies.

Main Results:

  • Definitions of lone AF are inconsistent across studies, hindering comparability.
  • The prevalence of lone AF has decreased with improved diagnostic techniques.
  • No unique pathophysiological mechanisms distinguish lone AF from other forms of AF.
  • The term "lone AF" offers limited utility in guiding treatment decisions.

Conclusions:

  • The term "lone AF" is outdated, inconsistently defined, and lacks clinical utility.
  • It is recommended to discontinue the use of the term "lone AF" to improve diagnostic accuracy and treatment strategies for atrial fibrillation.

Keywords:
idiopathic atrial fibrillationlone atrial fibrillationwhite paper

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