European Heart Journal Advance Access originally published online on September 1, 2005
European Heart Journal 2005 26(23):2556-2561; doi:10.1093/eurheartj/ehi483
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up
1Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
2Division of Biostatistics, Mayo Clinic, Rochester, MN, USA
3Department of Neurology, Mayo Clinic, Rochester, MN, USA
Received 24 May 2005; revised 12 July 2005; accepted 11 August 2005; online publish-ahead-of-print 1 September 2005.
* Corresponding author. Tel: +1 507 284 3581; fax: +1 507 284 3968. E-mail address: seward{at}mayo.edu
See page 2487 for the editorial comment on this article (doi:10.1093/eurheartj/ehi578)
Aims The objectives of this study were to determine the long-term outcome and the predictors of adverse events in patients originally diagnosed with lone atrial fibrillation (AF).
Methods and results This population-based historical cohort study comprised 46 residents of Olmsted County, MN, USA, with well-documented, clinically defined lone AF and a complete two-dimensional echocardiographic examination. The original echocardiographic videotape recordings were analysed in a blinded fashion for left atrial volume (LAV) and left ventricular ejection fraction. With 1296 person-years of follow-up, the median duration of AF was 27 (first quartile=24, third quartile=33) years. Twenty-three (50%) patients developed events. Cerebral infarction occurred in seven patients, myocardial infarction in 11, and congestive heart failure in 16. In a multivariable analysis, patients with indexed LAV 
32 mL/m2 had a significantly worse event-free survival (adjusted HR, 4.46; 95% CI, 1.56–12.74; P=0.005). All cerebral infarctions occurred in patients with an indexed LAV >32 mL/m2.
Conclusion Patients originally diagnosed with benign lone AF follow divergent courses based on LAV. Those originally diagnosed with lone AF and normal sized atria had a benign clinical course throughout the long-term follow-up. Patients with increased LAV at diagnosis or later during the follow-up experienced adverse events.
Key Words: Lone atrial fibrillation • Left atrial volume • Echocardiography • Cerebral infarction
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in EHJ:
- First comes diagnosis then comes treatment: an underappreciated paradigm in atrial fibrillation management
- Andreas Bollmann
EHJ 2005 26: 2487-2489.[Extract] [FREE Full Text]
This article has been cited by other articles:
|
|
 |
|
  F. Belluzzi, L. Sernesi, P. Preti, F. Salinaro, M. L. Fonte, and S. Perlini Prevention of recurrent lone atrial fibrillation by the angiotensin-II converting enzyme inhibitor ramipril in normotensive patients. J. Am. Coll. Cardiol., January 6, 2009; 53(1): 24 - 29. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Fatema, K. R. Bailey, G. W. Petty, I. Meissner, M. Osranek, A. A. Alsaileek, B. K. Khandheria, T. S. Tsang, and J. B. Seward Increased Left Atrial Volume Index: Potent Biomarker for First-Ever Ischemic Stroke Mayo Clin. Proc., October 1, 2008; 83(10): 1107 - 1114. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. A. Schoonderwoerd, M. D. Smit, L. Pen, and I. C. Van Gelder New risk factors for atrial fibrillation: causes of 'not-so-lone atrial fibrillation' Europace, June 1, 2008; 10(6): 668 - 673. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. F Tops, E. E van der Wall, M. J Schalij, and J. J Bax Multi-modality imaging to assess left atrial size, anatomy and function Heart, November 1, 2007; 93(11): 1461 - 1470. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Messika-Zeitoun, M. Bellamy, J.-F. Avierinos, J. Breen, C. Eusemann, A. Rossi, T. Behrenbeck, C. Scott, J. A. Tajik, and M. Enriquez-Sarano Left atrial remodelling in mitral regurgitation--methodologic approach, physiological determinants, and outcome implications: a prospective quantitative Doppler-echocardiographic and electron beam-computed tomographic study Eur. Heart J., July 2, 2007; 28(14): 1773 - 1781. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Struthers and C. Lang The potential to improve primary prevention in the future by using BNP/N-BNP as an indicator of silent 'pancardiac' target organ damage: BNP/N-BNP could become for the heart what microalbuminuria is for the kidney Eur. Heart J., July 2, 2007; 28(14): 1678 - 1682. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Frost Lone Atrial Fibrillation: Good, Bad, or Ugly? Circulation, June 19, 2007; 115(24): 3040 - 3041. [Full Text] [PDF]
|
|
|
|
|
|
A. Jahangir, V. Lee, P. A. Friedman, J. M. Trusty, D. O. Hodge, S. L. Kopecky, D. L. Packer, S. C. Hammill, W.-K. Shen, and B. J. Gersh Long-Term Progression and Outcomes With Aging in Patients With Lone Atrial Fibrillation: A 30-Year Follow-Up Study Circulation, June 19, 2007; 115(24): 3050 - 3056. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Berruezo, D. Tamborero, L. Mont, B. Benito, J. M. Tolosana, M. Sitges, B. Vidal, G. Arriagada, F. Mendez, M. Matiello, et al. Pre-procedural predictors of atrial fibrillation recurrence after circumferential pulmonary vein ablation Eur. Heart J., April 1, 2007; 28(7): 836 - 841. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. J. Manning and E. V. Gelfand Left Atrial Size and Postoperative Atrial Fibrillation: The Volume of Evidence Suggests it Is Time to Break an Old Habit J. Am. Coll. Cardiol., August 15, 2006; 48(4): 787 - 789. [Full Text] [PDF]
|
|
|
|
|
|
M. Osranek, K. Fatema, F. Qaddoura, A. Al-Saileek, M. E. Barnes, K. R. Bailey, B. J. Gersh, T. S.M. Tsang, K. J. Zehr, and J. B. Seward Left Atrial Volume Predicts the Risk of Atrial Fibrillation After Cardiac Surgery: A Prospective Study J. Am. Coll. Cardiol., August 15, 2006; 48(4): 779 - 786. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Other articles noted Evid. Based Med., June 1, 2006; 11(3): 95 - 96. [Full Text] [PDF]
|
|
|
|
|
|
M. Rienstra and I. C. Van Gelder Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up Eur. Heart J., March 2, 2006; 27(6): 756 - 756. [Full Text] [PDF]
|
|
|
|
|
|
M. Osranek and J. B. Seward Left atrial volume predicts cardiovascular events in patients originally diagnosed with lone atrial fibrillation: three-decade follow-up: reply Eur. Heart J., March 2, 2006; 27(6): 756 - 756. [Full Text] [PDF]
|
|
|
|
|
|
A. Bollmann First comes diagnosis then comes treatment: an underappreciated paradigm in atrial fibrillation management Eur. Heart J., December 1, 2005; 26(23): 2487 - 2489. [Full Text] [PDF]
|
|