Libin Cardiovascular Institute of Alberta/University of Calgary, Calgary, Alberta, Canada.
Department of Cardiology, Thoraxcenter, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
J Am Coll Cardiol. 2014 May 6;63(17):1715-23. doi: 10.1016/j.jacc.2014.01.023. Epub 2014 Feb 12.
The historical origin of the term "lone atrial fibrillation" (AF) predates by 60 years our current understanding of the pathophysiology of AF, the multitude of known etiologies for AF, and our ability to image and diagnose heart disease. The term was meant to indicate AF in patients for whom subsequent investigations could not demonstrate heart disease, but for many practitioners has become synonymous with "idiopathic AF." As the list of heart diseases has expanded and diagnostic techniques have improved, the prevalence of lone AF has fallen. The legacy of the intervening years is that definitions of lone AF in the literature are inconsistent so that studies of lone AF are not comparable. Guidelines provide a vague definition of lone AF but do not provide direction about how much or what kind of imaging and other testing are necessary to exclude heart disease. There has been an explosion in the understanding of the pathophysiology of AF in the last 20 years in particular. Nevertheless, there are no apparently unique mechanisms for AF in patients categorized as having lone AF. In addition, the term "lone AF" is not invariably useful in making treatment decisions, and other tools for doing so have been more thoroughly and carefully validated. It is, therefore, recommended that use of the term "lone AF" be avoided.
“孤立性心房颤动”（AF）一词的历史起源早于我们目前对 AF 病理生理学的理解 60 年，AF 的许多已知病因，以及我们对心脏病进行成像和诊断的能力。该术语旨在表示在随后的检查中无法发现心脏病的患者的 AF，但对许多医生来说，它已成为“特发性 AF”的同义词。随着心脏病种类的增加和诊断技术的提高，孤立性 AF 的患病率有所下降。多年来的遗留问题是，文献中孤立性 AF 的定义不一致，因此孤立性 AF 的研究无法进行比较。指南对孤立性 AF 提供了一个模糊的定义，但没有说明需要进行多少或哪种类型的成像和其他检查来排除心脏病。特别是在过去 20 年中，对 AF 病理生理学的理解有了突飞猛进的发展。然而，在被归类为孤立性 AF 的患者中，AF 并没有明显独特的机制。此外，在做出治疗决策时，术语“孤立性 AF”并不总是有用，并且其他用于此目的的工具已经得到更彻底和仔细的验证。因此，建议避免使用“孤立性 AF”一词。
