Clinical course of lone atrial fibrillation since first symptomatic arrhythmic episode

This study indicates that arrhythmia recurs in ≈60% of patients during the first episode of lone AF diagnosed in the field; however, sustained AF rarely develops. A low risk of stroke was seen, particularly in patients aged <70 years. In elderly patients, the incidence of stroke was higher; however, it was not significantly different from that found in age-matched controls, leaving no clear indication for anticoagulant treatment. Survival was not significantly different in patients with AF compared with control groups, but patients with AF, particularly the oldest subjects, had a higher incidence of sudden death.