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Timothy J. Ingall, MBBS, PhD
Mayo Clinic Rochester, Minn

JAMA. 1988;260(20):3006.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor. —

In the May 20 issue of JAMA, several questions were asked about the management of paroxysmal atrial fibrillation.¹ Dr Dunn advises that the patient undergo long-term anticoagulation therapy with warfarin sodium. I would like to make two comments. First, the article that Dr Dunn refers to (The Framingham Study) does not document an increased risk of embolism in patients with paroxysmal atrial fibrillation but rather documents an increase in overall mortality in patients with chronic atrial fibrillation.² Second, there is no adequately documented evidence that long-term anticoagulation therapy decreases the risk of systemic embolization in patients with any form of atrial fibrillation. In addition, the patient in question can be characterized as having lone atrial fibrillation, ie, atrial fibrillation with no evidence of any other primary cardiac disorder. There is evidence that for patients 60 years of age and younger, lone atrial fibrillation, whether . . . [Full Text PDF of this Article]

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