Lone Atrial Fibrillation
Key result
Avoid the term lone atrial fibrillation in favor of underlying disease and validated risk scores.
Why the study?
Definitions of lone AF in the literature are inconsistent, making studies non-comparable, and guidelines provide only vague definitions without direction on necessary testing to exclude heart disease.
Population
Patients with atrial fibrillation previously categorized as having 'lone AF'
Design
Review
Authors
Discussion
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Implication
The historical term 'lone AF' should be abandoned in clinical practice in favor of detailed characterization of underlying heart disease and validated risk scores.
Key Points
- To evaluate the historical origin, pathophysiological basis, diagnostic consistency, and clinical utility of the diagnostic label lone atrial fibrillation.
- Working group assessed historical definitions, guidelines, and contemporary pathophysiological insights regarding lone atrial fibrillation.
- Evaluated the criteria for excluding concomitant cardiovascular and pulmonary diseases across 125 published reports identified via PubMed.
- Reported lone atrial fibrillation prevalence varied widely from 0.2% to 68% across cohorts, dropping from 10% to 3% in the Euro Heart Survey under more stringent criteria.
- Across 125 published studies, coronary heart disease was excluded in 69%, whereas only 23% of studies excluded individuals aged >60 years.
- No unique pathophysiological mechanisms exist for lone atrial fibrillation, and the classification lacks utility for therapeutic decision-making compared to validated risk stratification tools.
Structured PICO
P
Population
Patients with atrial fibrillation previously categorized as having 'lone AF'
The historical term 'lone AF' should be abandoned in clinical practice in favor of detailed characterization of underlying heart disease and validated risk scores.
Cite This Study
Wyse et al. (2014) conducted a review in Atrial fibrillation. Diagnosis of 'lone atrial fibrillation' was evaluated. The term 'lone atrial fibrillation' lacks mechanistic or clinical utility, is inconsistently defined, and should be avoided in favor of specifying underlying heart disease and validated risk scores.