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September 8, 2004

Parental Atrial Fibrillation as a Risk Factor for Atrial Fibrillation in Offspring

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(10):1174-1175. doi:10.1001/jama.292.10.1174-b

To the Editor: Dr Fox and colleagues1 report the results of an analysis performed within the Framingham Heart Study, showing that parental atrial fibrillation (AF) increases the future risk for AF in offspring. However, the reasons for the genetic susceptibility to developing AF remained unexplained. One factor the authors did not investigate was the extent to which the genetic risk of AF varied according to left atrial size in parents and offspring. We have previously reported an echocardiographic study on 251 healthy young individuals and their parents in which we found that parental and offspring atrial dimensions were significantly correlated with one another.2 The proportion of variance in the offspring left atrial dimension explained by parental atrial dimension was 3.6%, increasing to 6.3% when left ventricular mass and left ventricular diastolic function were accounted for. Left atrial enlargement is an important predictor of AF,3 and spontaneous conversion to sinus rhythm during AF has been shown to be associated with smaller left atrial volumes.4 It would be of interest if the Framingham investigators could assess left atrial dimension in these persons to determine whether the genetic susceptibility to developing AF in the offspring may be at least partially explained by the inheritance in left atrial size.