title: Impaired transport function of the left atrium in patients with lone paroxysmal atrial fibrillation.
abstract: BACKGROUND
  Although lone paroxysmal atrial fibrillation (LPAF) is clinically defined as an arrhythmia that occurs in the absence of structural heart disease, it has been suggested that the presence of anatomical substrate is related to LPAF. The aim of the present study is to determine whether structural and functional remodeling of the left atrium (LA) occurs in patients with LPAF, and to identify whether frequent episodes of atrial fibrillation (AF) contribute to LA remodeling.
  
  
  RESULTS
  Forty-five patients who diagnosed as LPAF and age-, gender-, and body mass index-matched healthy control subjects (n = 45) were enrolled. Patients were grouped based on the frequency of AF episodes. An echocardiography was performed >2 weeks after last episode of AF without antiarrhythmic drugs. There were no statistical differences in left ventricular (LV) diastolic and systolic functions as well as baseline characteristics between patients and controls, whereas, patients had significantly larger LA volume (LAV), lower active LA emptying fraction (LAEF(active) , P = 0.009) and total LAEF (LAEF(total) , P = 0.005) compared with controls. Passive LAEF (LAEF(passive) ) was not different between patients and controls (P = 0.664). LAEF(active) was significantly depressed in patients with frequent episodes of AF than the others (P = 0.034).
  
  
  CONCLUSIONS
  Compared with healthy controls, patients with LPAF had increased LAV and depressed LAEF(active) and LAEF(total) without accompanying compensatory increase in LAEF(passive) . LAEF(active) was influenced by frequent episodes of AF. These findings may support the hypothesis that LPAF is "not-so-lone AF" and related to the concealed cardiac dysfunctions.
authors.affiliation: Division of Cardiology, Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seung Yong
authors.initials: SY
authors.lastname: Shin
authors.forename: Hong Euy
authors.initials: HE
authors.lastname: Lim
authors.forename: Un Jung
authors.initials: UJ
authors.lastname: Choi
authors.forename: Cheol Ung
authors.initials: CU
authors.lastname: Choi
authors.forename: Seong Hwan
authors.initials: SH
authors.lastname: Kim
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Eung Ju
authors.initials: EJ
authors.lastname: Kim
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Chang Gyu
authors.initials: CG
authors.lastname: Park
authors.forename: Hong Seog
authors.initials: HS
authors.lastname: Seo
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Oh
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Kim
mesh_terms: D016279:Atrial Function, Left / Q000502:physiology; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014693:Ventricular Fibrillation / Q000000981:diagnostic imaging / Q000473:pathology