DOPPLER-ECHOCARDIOGRAPHY IN SUSPECTED LONE ATRIAL-FIBRILLATION

Echocardiography is frequently required in patients with atrial fibril lation (AF) to exclude underlying heart disease. In the present invest igation the authors evaluated 56 patients with paroxysmal AF (PAF) (27 men, 29 women, mean age 54 +/- 11.3 years) in whom lone AF was suspec ted on clinical grounds. M-mode, B-mode, and Doppler examination were performed and measurements taken according to American Society of Echo cardiography criteria. Left atrial diameter, left and right atrial vol umes, left ventricular (LV) diameters, LV fractional shortening, and D oppler indexes of LV diastolic function were not different in patients with PAF in comparison with those of a control group of 56 age-matche d subjects free from cardiovascular diseases. Echocardiographic examin ation results were entirely normal in 32/56 patients (57%) vs 39/56 of the control group (69%). Mitral valve prolapse was found in five pati ents (9%), but only one showed mild mitral regurgitation. Doppler exam ination disclosed a mild (+/++) mitral regurgitation in eight patients and a small aortic or pulmonary diastolic flow in four and two patien ts, respectively, in the absence of significant morphologic valvular a bnormalities. In these patients the sizes of heart chambers were entir ely normal. Aneurysm of the interatrial septum was found in one patien t and an increased thickness of the epipericardial junction in another two patients. Finally two patients had a small increase of right atri al volume without demonstrable causes. The results suggest that lone A F can be correctly suspected on the basis of clinical findings (histor y, physical examination, and EGG) and that in these patients echocardi ography rarely discloses organic heart disease.