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Lone atrial fibrillation - a diagnosis of exclusion.

Atrial fibrillation (AF) is the most common sustained rhythm disturbance, increasing prevalence with age, in particular in patients with cardiovascular disease. On the other hand, a subset of patients with AF being <60 years old and no evidence of underlying cardiovascular disease, and laboratory tests including thyroid function, echocardiography and exercise" test is well described. This is the called lone AF, where there is no previous cardiovascular disease, and the etiology is unknown. However, in the last years, some new factors have been related to play a role or be associated to incident AF. Conditions such as obesity, sleep apnea, alcohol intake, exercise practice, or genetic factors are associated with the development of this common arrhythmia and make the exclusion diagnosis of lone AF more complicated. The aim of the present manuscript is to provide an overview of these new risk factors for AF, which are becoming of special interest in the study of this common arrhythmia.