A Clinical Profile of Idiopathic Atrial Fibrillation

SUMMARY

Thirty patients felt to represent a "pure" group with idiopathic atrial fibrillation were observed. The onset of the arrhythmia often occurred after emotional or physical exhaustion, coughing, vomiting, standing erect, or overindulging in food and alcohol, suggesting that some reflex vagal activity, or an "excitatory factor," or both, may play a causal role. No patients in the series had congestive heart failure, coronary insufficiency, embolic phenomena, or required reversion to sinus rhythm by electrical means. Bouts of atrial fibrillation in these individuals without known heart disease are probably functional and benign. The occurrence of cardiac signs or symptoms out of proportion to those due to the arrhythmia itself suggests that underlying heart disease may be present and that the patient may not have idiopathic atrial fibrillation.