Echocardiography in patients with clinically suspected lone atrial fibrillation rarely disclosed organic heart disease, with entirely normal results in 57% of patients versus 69% of controls.
Case-Control (n=112)
Does echocardiography identify underlying organic heart disease in patients with clinically suspected lone paroxysmal atrial fibrillation?
In patients with clinically suspected lone atrial fibrillation, echocardiography rarely discloses organic heart disease, suggesting clinical findings alone are highly predictive.
Absolute Event Rate: 57% vs 69%
Echocardiography is frequently required in patients with atrial fibrillation (AF) to exclude underlying heart disease. In the present investigation the authors evaluated 56 patients with paroxysmal AF (PAF) (27 men, 29 women, mean age 54+/-11.3 years) in whom lone AF was suspected on clinical grounds. M-mode, B-mode, and Doppler examination were performed and measurements taken according to American Society of Echocardiography criteria. Left atrial diameter, left and right atrial volumes, left ventricular (LV) diameters, LV fractional shortening, and Doppler indexes of LV diastolic function were not different in patients with PAF in comparison with those of a control group of 56 age-matched subjects free from cardiovascular diseases. Echocardiographic examination results were entirely normal in 32/56 patients (57%) vs 39/56 of the control group (69%). Mitral valve prolapse was found in five patients (9%), but only one showed mild mitral regurgitation. Doppler examination disclosed a mild (+/++) mitral regurgitation in eight patients and a small aortic or pulmonary diastolic flow in four and two patients, respectively, in the absence of significant morphologic valvular abnormalities. In these patients the sizes of heart chambers were entirely normal. Aneurysm of the interatrial septum was found in one patient and an increased thickness of the epipericardial junction in another two patients. Finally two patients had a small increase of right atrial volume without demonstrable causes. The results suggest that lone AF can be correctly suspected on the basis of clinical findings (history, physical examination, and ECG) and that in these patients echocardiography rarely discloses organic heart disease.
Galanti et al. (Sat,) conducted a case-control in Suspected lone atrial fibrillation (n=112). Echocardiography (M-mode, B-mode, and Doppler) vs. Age-matched healthy controls was evaluated on Entirely normal echocardiographic examination results. Echocardiography in patients with clinically suspected lone atrial fibrillation rarely disclosed organic heart disease, with entirely normal results in 57% of patients versus 69% of controls.