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The basics of LAF and PLAF

 

 

 

LAF and PLAF are the terms reserved for cases of atrial fibrillation where no known or detectable underlying medical or physical pathology or abnormality can be detected as a cause for the afib. Individuals who suffer from LAF or PLAF have normal hearts apart from their occasional or recurrent attacks of atrial fibrillation. The term “Paroxysmal” refers to the occasional or intermittent nature of the attacks, and the “Lone” term refers to the occurrence of afib in a “lone” manner -- that is, accompanied by no other discernible pathology.

 

Globally, there are many millions of PLAF sufferers. A sufferer’s first attack is often in their 50’s, but may occur at much younger ages. Prevalence in the population increases progressively in each successive age cohort. Around 10% of all those over 80 have AF of all types, increasing to nearly 20% in those over 85 [1,2,3].

The traditional prognosis or outlook for PLAF sufferers is not thrilling. Basically, the doctor or cardiologist will inform the patient that the attacks will become ever more frequent until they merge to become continuous (Persistent, Chronic or Permanent AF); that available medications will all have a limited duration of efficacy, eventually losing their effect; and that you might be able to have an ablation -- an operation (or series of operations) with some risk of stroke or other extremely serious outcomes, and for which success is defined in various ways in terms of degree of elimination of AF and the number of years of elimination before another operation will probably be required.

 

All atrial fibrillation episodes carry some risk of stroke, but this increases with the frequency and duration of attacks, and also with age.

 

When a sufferer reaches the stage of Permanent AF, and this is not able to be reversed, other deadly conditions like heart failure then become much more likely.

 

 

 

 

 

[1] Go, A. S., Hylek, E. M., Phillips, K. A., Chang, Y., Henault, L. E., Selby, J. V., & Singer, D. E. (2001). Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. Jama,285(18), 2370-2375.

 

[2] Miyasaka, Y., Barnes, M. E., Gersh, B. J., Cha, S. S., Bailey, K. R., Abhayaratna, W. P., ... & Tsang, T. S. (2006). Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation, 114(2), 119-125.

 

[3] Heeringa, J., van der Kuip, D. A., Hofman, A., Kors, J. A., van Herpen, G., Stricker, B. H. C., ... & Witteman, J. C. (2006). Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. European heart journal,27(8), 949-953.

 

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