Lone Atrial Fibrillation in Elderly Persons

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Abstract
THE ABSENCE of a consensus about thromboembolic risk in patients with lone atrial fibrillation (LAF) derives in part from its definition and in part from the infrequency with which LAF is diagnosed within a single institution or medical practice. Different patient populations with nonvalvular heart disease and different clinical characteristics have different event rates of thromboembolism. A previous study1 of patients aged 60 years and younger with LAF (and no hypertension) at our institution documented a low incidence of thromboembolism, leading to the conclusion that long-term anticoagulant therapy probably was not justified in such patients in the absence of documented embolism. These findings seemed to be at variance with a Framingham study report2 in which the patient population was older and hypertension was not excluded. For these reasons, the present study was designed to test the hypothesis that LAF is associated with a higher risk of thromboembolic cerebrovascular and cardiovascular events in patients older than 60 years than in younger patients.