Atrial fibrillation--a review of course and prognosis.

Four recent major studies concerning the prognosis in atrial fibrillation (AF) are reviewed. The one-year mortality ranged from 16.0 to 0.2%, highest in elderly, hospitalized patients with chronic AF and lowest in young individuals with paroxysmal AF without other heart disease. The recognized clinical impression that the prognosis in AF is determined by age, type of AF and clinical status is thus confirmed. In three studies, however, the prognosis in lone atrial fibrillation seemed to be poorer than previously thought. The overall rate of thromboembolic complications in AF was about 25% in several studies. The effectiveness of coumarin drugs in the prophylaxis of these complications is not proved, and the time has come to subject them to more careful clinical investigation.