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Spontaneous Conversion of Long-Standing Atrial Fibrillation/Flutter
Lynda E Rosenfeld1, Edinrin R Obasare1, Eric Bader1
1Section of Cardiovascular Medicine, Dana 3, Yale University School of Medicine, New Haven, Connecticut.
The American Journal of Cardiology
|July 29, 2020
Summary
Spontaneous conversion from atrial fibrillation (AF) to sinus rhythm is rare. Three cases show this can occur due to severe atrial myopathy, not rheumatic heart disease or digoxin.
Area of Science:
- Cardiology
- Electrophysiology
- Pathology
Background:
- Spontaneous conversion of long-standing atrial fibrillation (AF) or flutter (AFl) to sinus rhythm is infrequently documented.
- Historically, this phenomenon was linked to rheumatic mitral valve disease and digoxin treatment.
Observation:
- Three contemporary cases of spontaneous rhythm conversion are presented.
- Patients progressed from AF to slow AFl, then to slow sinus or junctional rhythm.
- None had rheumatic heart disease or were treated with digoxin.
Findings:
- The observed spontaneous conversions were not associated with traditional risk factors.
- The cases suggest a link between severe atrial myopathy, characterized by scar and inflammation, and this uncommon conversion phenomenon.
Implications:
- These findings broaden the understanding of spontaneous rhythm conversion in atrial arrhythmias.
- The study highlights atrial myopathy as a potential underlying mechanism for this rare event.
- Further research into atrial myopathy could offer new insights into managing atrial fibrillation and flutter.
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