What Is Lone Atrial Fibrillation

What Is Lone Atrial Fibrillation?

Lone Atrial Fibrillation (LA) is a condition where there are no ventricular beats during atrioventricular conduction. There are two types of LA: 1) Ventricular Hypertrophy 2) Ventricular Dysplasia.

Ventricular Hypertrophy:

Ventricular hypertrophic cardiomyopathy (HCM) is a genetic heart disease that results from mutations in the atrial natriuretic peptide gene (ANP). The ANP encodes an enzyme called the alpha-atrial natriuretic peptide synthetase which catalyzes the release of renin into arterial blood. Renin is a hormone produced by the adrenal glands which helps maintain normal blood pressure.

When the renin levels become too low, then the body’s blood pressure drops causing hypertension.

In HCMs, the renin levels are not high enough to produce adequate vasodilation and blood flow to the heart muscle is impaired leading to dilated pupils and tachycardia. These symptoms may lead to sudden death if left untreated.

Ventricular Dysplasia:

Ventricular dysplasia is a form of cardiomyopathy that results from changes in the fetal heart development. These changes lead to an underdeveloped ventricular myocardium (heart muscle). If mild, then it can often be asymptomatic.

However, severe forms can lead to sudden heart failure and death. In some cases, an individual may have no symptoms throughout their life.

The most common causes of sudden death in individuals with this condition is a result of an abnormal heart rhythm called ventricular fibrillation or a heart attack. Any pain or discomfort felt by an individual with this condition is usually a sign that the heart attack has already occurred and death is near.

How Is It Treated?

There is currently no known cure for lone atrial fibrillation. However, there are some treatments that can help alleviate the symptoms. Some of these include:

Anti-clotting medications like Warafin or Clopidogrel help the blood thin so that it flows more freely

Rate-controlling drugs like Betablockers or Calcium-Channel Blockers can help slow heart rate and reduce stress on the heart

Radiofrequency ablation, an invasive procedure, can also be used in some cases to destroy parts of the atria

A combination of these treatments can help many patients manage the condition effectively and lead an overall healthy life.

Ventricular Fibrillation:

Ventricular fibrillation is an irregular and chaotic heart rhythm that leads to severely impaired blood flow. This is a medical emergency and immediate treatment is necessary to prevent death or brain damage. It can be caused by a number of heart diseases, including lone atrial fibrillation.

If blood flow is not restored within minutes it causes the heart to stop pumping altogether. This is known as Sudden Cardiac Arrest (SCA). It is the leading cause of death in the Western world.

What Are The Complications?

If an individual goes into ventricular fibrillation, then immediate cardiopulmonary resuscitation (CPR) is required to prevent death or brain damage. Without proper CPR, death usually occurs within 6-8 minutes.

Sources & references used in this article:

The natural history of lone atrial fibrillation by SL Kopecky, BJ Gersh, MD McGoon… – … England Journal of …, 1987 – Mass Medical Soc

Histological substrate of atrial biopsies in patients with lone atrial fibrillation by A Frustaci, C Chimenti, F Bellocci, E Morgante… – Circulation, 1997 – Am Heart Assoc

Long-lasting sport practice and lone atrial fibrillation by L Mont, A Sambola, J Brugada, M Vacca… – European heart …, 2002 – academic.oup.com

Prevention of atrial fibrillation recurrence by statin therapy in patients with lone atrial fibrillation after successful cardioversion by CW Siu, CP Lau, HF Tse – The American journal of cardiology, 2003 – Elsevier

Characteristics and prognosis of lone atrial fibrillation: 30-year follow-up in the Framingham Study by FN Brand, RD Abbott, WB Kannel, PA Wolf – Jama, 1985 – jamanetwork.com

Common variants in KCNN3 are associated with lone atrial fibrillation by PT Ellinor, KL Lunetta, NL Glazer, A Pfeufer, A Alonso… – Nature …, 2010 – nature.com

Familial aggregation in lone atrial fibrillation by PT Ellinor, DM Yoerger, JN Ruskin, CA MacRae – Human genetics, 2005 – Springer

Electrophysiological properties in chronic lone atrial fibrillation. by K Kumagai, S Akimitsu, K Kawahira, F Kawanami… – Circulation, 1991 – Am Heart Assoc

Lone atrial fibrillation in vigorously exercising middle aged men: case-control study by J Karjalainen, UM Kujala, J Kaprio, S Sarna… – Bmj, 1998 – bmj.com