P A Friedman

Dr P A Friedman, Mayo Clinic, Rochester, MN, USA; friedman.paul@mayo.edu

STUDY QUESTIONS

In patients newly diagnosed with lone atrial fibrillation (AF) and without structural heart disease, what is the risk of progression to permanent AF, congestive heart failure (CHF), stroke, and death? Which factors predict these outcomes?

STUDY DESIGN

Design:

inception cohort followed up for a median 26.8 years (range 2.5–42.2 y).

Setting:

Olmsted County, Minnesota, USA.

Patients:

76 patients <60 years of age (mean age 44 y, 78% men) with AF first documented by electrocardiography between 1950 and 1980. Patients were categorised into 3 AF types: (i) paroxysmal, if terminated spontaneously (n = 34); (ii) persistent, if it could be terminated by medication or electrical intervention (n = 37); and (iii) permanent, if sinus rhythm could not be restored or maintained despite intervention (n = 5).

Exclusion criteria were coronary artery or valvular disease, cardiomyopathy, cardiomegaly, pre-excitation syndrome, history of …