Left ventricular diastolic dysfunction in patients with so-called lone atrial fibrillation

Lone atrial fibrillation (AF) is defined by the absence of identifiable cau ses of AF, but its hemodynamics have not been investigated. Twenty-eight pa tients with lone AF were compared,vith 14 control patients referred for Wol ff-Parkinson-White ablation, Transthoracic and transesophageal echocardiogr aphy were performed to rule out structural heart disease, followed by trans septally performed complete hemodynamic evaluation of the left heart systol ic and diastolic function. There was no evidence of diastolic dysfunction a ccording to echocardiographic criteria in AF and control patients. There wa s no difference in echocardiographic measurements, except for a significant ly higher inferosuperior left atrial dimension seen in the four-chamber api cal view in AF patients (51 +/- 10 vs 40 +/- 6 mm, P = 0.03). Hemodynamic e valuation showed that end-diastolic left ventricular pressure and the nadir of the left atrial Y descent were significantly higher in lone AF patients versus controls: 13 +/- 5 versus 8 +/- 3 mmHg (P = 0.001) and 6.7 +/- 3 ve rsus 4.6 +/- 2.7 mmHg (P = 0.05). Our results demonstrated the presence of diastolic left heart dysfunction in patients with so-called lone AF.