title: Work-up and management of lone atrial fibrillation: results of the European Heart Rhythm Association Survey.
abstract: The purpose of this European Heart Rhythm Association (EHRA) survey was to explore the work-up and management of lone atrial fibrillation (AF) among the European centres. Thirty-two European centres, all members of the EHRA electrophysiology (EP) research network, responded to this survey and completed the list of questions. The prevalence of lone AF has been reported to be ≤10% by 19 (60%) of the participating centres. The presence of isolated left atrial enlargement and left ventricular diastolic dysfunction represent heart disease according to 50 and 84% of the centres, respectively, and exclude the diagnosis of lone AF. Fifty-nine per cent of responders do not routinely consider genetic testing in lone AF patients. The initial therapeutic approach in symptomatic paroxysmal lone AF is antiarrhythmic drug therapy as reported by 31 (97%) of the centres. Pulmonary vein isolation only is the first ablation strategy for patients with symptomatic persistent lone AF at 27 (84%) of the responding centres. Assessment for sleep apnoea, obesity, and intensive sports activity in lone AF is performed at 27 (84%) centres. In conclusion, this EP Wire survey confirms that the term 'lone AF' is still used in daily practice. The work-up typically includes screening for known risk factors but not genetic testing. The preferred management of paroxysmal lone AF is rhythm control with antiarrhythmic drugs, whereas pulmonary vein isolation is the first ablation strategy for the majority of patients with symptomatic persistent lone AF.
authors.affiliation: Department of Cardiology, Maastricht University Medical Centre, PO Box 5800, Maastricht, the Netherlands l.pison@mumc.nl.
authors.forename: Laurent
authors.initials: L
authors.lastname: Pison
authors.affiliation: Hôpital Cardiologique du Haut Lévêque Université Victor Segalen Bordeaux II, Bordeaux, Pessac, France.
authors.forename: Mélèze
authors.initials: M
authors.lastname: Hocini
authors.affiliation: School of Medicine, University of Belgrade, Serbia and Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Tatjana S
authors.initials: TS
authors.lastname: Potpara
authors.affiliation: Institute of Cardiovascular Medicine and Science, Liverpool Heart & Chest Hospital, Liverpool, UK.
authors.forename: Derick
authors.initials: D
authors.lastname: Todd
authors.affiliation: Department of Heart Disease, Haukeland University Hospital and Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Blomström-Lundqvist
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods; D005060:Europe / Q000453:epidemiology; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D011667:Pulmonary Veins / Q000601:surgery; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Ablation; Antiarrhythmic drugs; Atrial fibrillation; EHRA survey; EP wire; Lone atrial fibrillation; Management