Spontaneous conversion of lone atrial fibrillation
MODENA, ITALY. Lone atrial fibrillation, that is atrial fibrillation (heart
palpitations) without underlying heart disease, is becoming an increasingly
common disorder. It manifests itself by irregular, rapid heartbeat and is often
accompanied by dizziness or breathlessness. It is most often intermittent
(paroxysmal) lasting anywhere from a few minutes to several days. Patients with
lone atrial fibrillation (LAF) who are hospitalized are often exposed to drug
infusions or direct current shock (cardioversion) in order to stop the
fibrillation and bring the heart rhythm back to normal.
Researchers at the University of Modena now report that the use of potentially
dangerous, time-consuming, and expensive treatments to normalize heart rhythm in
LAF patients may not be necessary in most cases. Their study involved 140
patients who were admitted to the University Hospital with LAF of recent onset.
The researchers found that 108 (77 per cent) of the patients reverted to normal
heart rhythm within 48 hours without any treatment at all. The average duration
of the LAF episodes was four hours. Extensive clinical examination of all
patients revealed that people whose LAF attack occurred during sleep had a
seven-fold higher probability of spontaneous conversion during the first 24
hours than did those whose attacks occurred during the day. Patients with a
high blood level of ANP (atrial natriuretic peptide) were 3.2 times more likely
to experience a spontaneous conversion than were patients with lower levels.
The researchers found no correlation between age, gender, duration of LAF or
left atrial dimension and the propensity for spontaneous conversion.
Mattioli, Anna Vittoria, et al. Clinical, echocardiographic, and hormonal
factors influencing spontaneous conversion of recent-onset atrial fibrillation
to sinus rhythm. American Journal of Cardiology, Vol. 86, August 1, 2000, pp.