Auricular fibrillation in man has generally been considered a result of myocardial damage.1 Observations in many cases by many observers make it appear that heart function may not be seriously impaired by this rhythm. Whether this abnormal cardiac rhythm, resulting from profound disturbance in the auricles, throws an added burden on the heart's efficiency, or whether it is one of several unimportant signs of impaired cardiac function, is worthy of consideration. Symptoms and signs of decreased cardiac reserve are found in hearts without this rhythm; etiologic and predisposing factors may be the same as are found in auricular fibrillation, and yet the patients present very similar clinical courses. Some hearts develop this rhythm so insidiously that the patient is but little inconvenienced, even though it becomes permanent. Others, after a period of decompensation coincident with the inception of the new rhythm, are tided over and compensate well for years.
COFFEN TH. THE FAVORABLE PROGNOSIS OF AURICULAR FIBRILLATION. JAMA. 1923;81(6):440–448. doi:10.1001/jama.1923.02650060010003
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