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Extra Atrial Disease in Patients with "Lone" Atrial Fibrillation

Jason Confino1, Daniel Edmundowicz1, Joan M Lacomis2

  • 1Cardiovascular Institute, University of Pittsburgh, Pittsburgh, PA, USA.

Journal of Atrial Fibrillation
|May 13, 2017
PubMed

Insights

Extraatrial diseases like atherosclerosis are common in lone atrial fibrillation (LAF) patients. Higher disease burden correlates with persistent AF and lower catheter ablation success, challenging LAF

Area of Science:

  • Cardiology
  • Electrophysiology
  • Vascular Medicine

Background:

  • Lone atrial fibrillation (LAF) is often viewed as a primary atrial electrophysiologic disorder.
  • However, clinical observations suggest a frequent co-occurrence of extraatrial conditions, such as atherosclerosis and metabolic disorders, in LAF patients.

Purpose of the Study:

  • To quantify the burden of extraatrial diseases in patients with LAF.
  • To investigate the correlation between extraatrial disease burden and arrhythmia characteristics, including pattern (paroxysmal vs. persistent) and catheter ablation outcomes.

Main Methods:

  • Assessment of atherosclerosis using computed tomographic vascular calcification and arterial pulse wave velocity in 46 LAF patients.
  • Evaluation for metabolic diseases including dyslipidemia, insulin resistance, and inflammation.
  • Catheter ablation was performed, and outcomes were analyzed in relation to disease burden.

Main Results:

  • A significant prevalence of atherosclerosis (57%) and metabolic diseases (70%) was observed in the LAF cohort.
  • Patients with persistent atrial fibrillation exhibited a greater extraatrial disease burden compared to those with paroxysmal AF.
  • A significant inverse relationship was found between catheter ablation success rates and the severity of extraatrial disease burden.

Conclusions:

  • Extraatrial diseases are highly prevalent in patients diagnosed with LAF.
  • The observed correlations between extraatrial disease burden and LAF characteristics suggest that LAF may not solely be a primary electrophysiologic disorder.
  • Further research is warranted to validate these findings and their implications for understanding LAF pathophysiology.
Abstract

Keywords:
AblationAtherosclerosisAtrialAtrial FibrillationDiabetes MellitusDyslipidemiaMetabolic Syndrome

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