The role of atrial ectopics in initiating paroxysmal atrial fibrillation.

Aims: To characterize the nature and timing of atrial ectopics preceding clinical episodes of paroxysmal atrial fibrillation.

Methods And Results: Holter recordings (n= 177, 60 patients, 58% male, mean age 61.7 +/- 11.

Circadian variation in atrial fibrillation in patients with frequent paroxysms.

Determinants of the duration of episodes of atrial fibrillation (AF) in patients with paroxysmal atrial fibrillation (PAF) are poorly understood. However, autonomic tone shows circadian variation and is known to affect atrial electrophysiology. We therefore compared the duration of episodes of AF with an onset during the day (08:00-22:00) to those with an onset during the night in a database of 24-hour ECG recordings in patients with frequent symptomatic PAF.

New trials in atrial fibrillation.

Large-scale clinical trials in atrial fibrillation (AF) now are addressing issues other than that of thromboembolic prophylaxis. The "rate versus rhythm" debated is fundamental--whether to accept the occurrence of AF and attempt control of the ventricular rate or to strive for the restoration and maintenance of sinus rhythm. The AFFIRM, PIAF, and RACE trials will provide information about the efficacy, costs, adverse effects, and benefits of attempting to maintain sinus rhythm.