What Is Lone AFib?

Reviewed by James Beckerman, MD, FACC on July 29, 2020

Atrial fibrillation (AFib) is an uneven heartbeat that's often too fast. It’s usually due to heart disease, and it's more common in people older than 60. But some younger people with no sign of heart disease or other health problems also get AFib. Some experts call this lone atrial fibrillation, lone AFib, or lone AF.

There’s a lot of debate about this term, though. Doctors don’t agree on what it means, or if it’s useful. Some say lone AFib may not even be a separate condition. People diagnosed with it might have heart problems that their doctors haven’t found.

Lone AFib Causes

AFib is the result of a mix-up in your heart’s electrical signals. Normally, these signals travel through your heart’s two upper chambers (atria) and two lower chambers (ventricles) smoothly. In both lone and classic AFib, the signals in the heart’s upper chambers are out of sync with the ones in the lower chambers. This makes your heart quiver and beat too fast.

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There are four types of lone AFib:

Paroxysmal. Episodes come and go, and they usually stop in 24 to 48 hours without treatment.

Persistent. Your uneven heart rhythm lasts a week or more and doesn’t go back to normal on its own.

Long-standing persistent. Symptoms are constant and last longer than a year.

Permanent. Your heart rhythm won’t go back to normal, even with treatment. You may need meds to control your heart rate and lower your chance of having a stroke.

Lone AFib Symptoms

Lone AFib doesn’t always cause symptoms. You may not know you have it until your doctor finds it during a routine exam.

If you do have symptoms, you might notice:

  • A racing heart or flip-flop feeling in your chest
  • Fatigue
  • Lightheadedness
  • Dizziness
  • Shortness of breath
  • Chest pain

Lone AFib Diagnosis

If you have symptoms of lone AFib or your doctor hears an irregular heartbeat, you’ll have tests to check for heart disease. These may include:

Electrocardiogram (EKG).This test uses sensors to record electrical signals as they travel through your heart.

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Holter monitor or event monitor. You take these wearable devices with you. A Holter monitor records your heart rhythms for 24 hours. An event monitor tracks your heart over weeks or months.

Echocardiogram. This test uses sound waves to create moving pictures of your heart.

Stress test. Your doctor measures your heart rate while you walk or run on a treadmill.

Chest X-rays and blood tests. These help rule out other problems that could cause your symptoms.

If you don't have heart disease, you may have lone AFib.

Lone AFib Risk Factors

People with lone AFib are healthy and don’t have classic risk factors like older age, high blood pressure, diabetes, and heart disease. Things that may contribute to lone AFib include:

  • Alcohol use
  • Taking part in endurance sports like ultramarathons or triathlons
  • Severe stress

Lone AFib Treatments

The usual way to treat lone AFib is with medicine that controls your heart rate or rhythm. If that fails, the next option is something called catheter ablation. In this procedure, your doctor threads a long, thin tube (catheter) through your blood vessels to your heart. Intense cold or heat applied through the catheter destroys the tissue that causes your uneven heart rhythm.

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Catheter ablation doesn’t work for everyone. A single treatment may help about 60% of people with lone AFib. About 70% get better with two or three treatments.

Lifestyle changes also play a huge role in lone AFib treatment. If you need to, shed extra pounds, stop smoking, and limit alcohol and -- if you haven’t already -- get regular low-intensity exercise. If you think your symptoms are due to intense physical training, cut back for a few months.

Lone AFib Outlook

As long you’re free of heart disease or other health problems, lone AFib shouldn't present long-lasting issues. It may show up again later, so be sure to follow up with your doctor.

WebMD Medical Reference

Sources

SOURCES:

Mayoclinic.org: “Atrial Fibrillation,” “Atrial Fibrillation Ablation.”

The Cardiology Advisor: “ ‘Lone’ Atrial Fibrillation: Finding Optimal Treatment Strategies,” “ ‘Lone’ Atrial Fibrillation: Lifestyle Management and Hybrid Procedures.”

Journal of the American College of Cardiology: “Lone Atrial Fibrillation: Does It Exist?”

Journal of Atrial Fibrillation: “Lone Atrial Fibrillation: Risk Factors, Triggers, and Ablation Techniques.”

European Heart Journal -- Cardiovascular Imaging: “Atrial function is altered in lone paroxysmal atrial fibrillation in male endurance veteran athletes.”

Cardiology in the Young: “Catheter ablation for lone atrial fibrillation in individuals aged under 35 years.”

Circulation: “Long-term progression and outcomes with aging in patients with lone atrial fibrillation: A 30-year follow-up study.”

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