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[Mid-term clinical and prognostic evaluation of idiopathic atrial fibrillation]
Insights
Idiopathic atrial fibrillation (AF) is common in cardiology clinics, with paroxysmal forms showing variable evolution but an excellent medium-term prognosis. Some cases may indicate underlying coronary artery disease.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Context:
- Idiopathic atrial fibrillation (AF) represents a significant portion of AF cases presenting in cardiology outpatient settings.
- Understanding the prevalence and clinical course of idiopathic AF is crucial for patient management.
- Previous studies have varied in their focus on specific AF subtypes and patient populations.
Purpose:
- To evaluate the prevalence, clinical characteristics, and medium-term outcomes of patients with idiopathic or lone atrial fibrillation.
- To assess the incidence of cardiovascular disease and hypertension development during follow-up.
- To investigate changes in left atrial size and the occurrence of thromboembolic events.
Summary:
- Forty-six patients with idiopathic AF were followed for 4.6 years; idiopathic AF constituted 19% of AF cases in the clinic.
- During follow-up, 26% developed cardiovascular disease or hypertension; left atrial size remained stable.
- No thromboembolic complications or deaths occurred, indicating an excellent medium-term prognosis for idiopathic AF.
Impact:
- Idiopathic AF is a frequent diagnosis in cardiology, necessitating awareness of its variable progression.
- The study suggests a favorable medium-term prognosis for idiopathic AF, particularly paroxysmal forms.
- Further research is warranted to explore the potential link between idiopathic AF and asymptomatic coronary artery disease.
Abstract:
Forty-six patients with idiopathic or lone atrial fibrillation (AF) underwent clinical evaluation in the cardiology outpatient department. The follow-up period was 4.6 +/- 2.5 years. The prevalence of idiopathic AF was 19% (89% paroxysmal and 11% permanent) in a population of 244 patients with atrial fibrillation. The global prevalence was 1.15% out of 4,000 patients examined over the same period. A history of paroxysmal atrial fibrillation over a 6 +/- 4 year period was obtained in 61% of the patients with idiopathic AF before the study. At inclusion, 24% of patients were asymptomatic. During follow-up, 12 patients (26%) developed cardiovascular disease and/or hypertension. The size of the left atrium was measured by echocardiography in 45 patients and reevaluated in 30 of them during follow-up without any statistically significant difference being observed between the two values. There were no thromboembolic complications or deaths during follow-up. These results show that idiopathic AF is not uncommon in cardiology clinics. The evolution of the paroxysmal forms is variable--but the medium-term prognosis is excellent. In some cases, idiopathic AF may be a manifestation of asymptomatic coronary artery disease but the relationship between the two pathologies has not been definitely established.