To the Editor: Kopecky and his colleagues (Sept. 10 issue)1 contribute a careful study of lone atrial fibrillation, distinguished by its quasi-prospective design. However, the authors may wish to address a problem of definition. They refer to Evans and Swann's classic paper defining “lone” as “in the absence of any other clinical evidence to suggest a primary cardiac disorder.”2 The implications of “clinical” become crucial, because 21 of the patients in the series of Kopecky et al. had interventricular conduction delay, 10 had axis deviations, and 2 had bundle-branch blocks. Why were such electrocardiographic abnormalities not cause for exclusion? Had.
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