Patton Kristen K, Zacks Eran S, Chang Joseph Y, Shea Marisa A, Ruskin Jeremy N, Macrae Calum A, Ellinor Patrick T
Cardiac Arrhythmia Service and Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA 02114, USA.
Pacing Clin Electrophysiol. 2005 Jul;28(7):630-8. doi: 10.1111/j.1540-8159.2005.00161.x.
In the face of increasing evidence of underlying genetic heterogeneity for lone atrial fibrillation (LAF), we undertook a clinical analysis of subjects to identify the phenotypic subsets of this arrhythmia.
We evaluated serial patients who presented with LAF between July 5, 2001 and December 19, 2003. Subjects underwent a standardized interview to elicit a detailed medical history, prior therapies, and precipitants of atrial fibrillation. The results of a physical exam, electrocardiogram and echocardiogram were reviewed. One hundred and eighty subjects with a mean age of 45 years (15-67 years) at the time of diagnosis were enrolled. The majority of patients originally presented with paroxysmal fibrillation (94%), and 7.8% progressed to permanent AF. Reported triggers for AF included sleeping (44%), exercise (36%), alcohol use (36%), and eating (34%). Women with LAF had distinct symptoms, triggers for episodic AF, and over one-fourth had an underlying rheumatologic condition. Several subsets of AF including familial AF (39%), exercise-induced AF (32%), and conduction system disease requiring pacemaker implantation (7%), were identified.
Family history, exercise as a trigger of AF, and a history of a pacemaker identified subtypes of LAF.
鉴于越来越多的证据表明孤立性房颤（LAF）存在潜在的基因异质性，我们对受试者进行了临床分析，以确定这种心律失常的表型亚组。
我们评估了2001年7月5日至2003年12月19日期间出现LAF的连续患者。受试者接受了标准化访谈，以获取详细的病史、既往治疗情况和房颤的诱发因素。回顾了体格检查、心电图和超声心动图的结果。共纳入180名诊断时平均年龄为45岁（15 - 67岁）的受试者。大多数患者最初表现为阵发性房颤（94%），7.8%进展为永久性房颤。报告的房颤诱发因素包括睡眠（44%）、运动（36%）、饮酒（36%）和进食（34%）。患有LAF的女性有不同的症状、发作性房颤的诱发因素，超过四分之一的患者有潜在的风湿性疾病。确定了几种房颤亚组，包括家族性房颤（39%）、运动诱发的房颤（32%）和需要植入起搏器的传导系统疾病（7%）。
家族史、运动作为房颤的诱发因素以及起搏器植入史可确定LAF的亚型。
