Document Detail


Recovery of atrial systolic function after pharmacological conversion of chronic atrial fibrillation to sinus rhythm: a Doppler echocardiographic study.
MedLine Citation:
PMID:  9038694     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the time course of the recovery of atrial mechanical function after pharmacological cardioversion of chronic atrial fibrillation to sinus rhythm. PATIENTS AND METHODS: 21 patients (12 male, 9 female, aged 37-77 years) with chronic atrial fibrillation (< 6 months) were followed up by serial transmitral pulsed Doppler echocardiography. Echocardiographic studies were performed within the first 24 hours and on day 8, 15, and 30 after cardioversion. RESULTS: There was a significant increase (mean (SD)) in the peak A-wave velocity (from 0.35 (0.10) on day 1 to 0.50 (1.73) on day 8, and thereafter a gradual increase to 0.61 (0.14) m/s on day 30). Similarly, integrated late atrial velocities increased from 4.50 (1.46) on day 1 to 5.61 (1.73) on day 8 and 5.97 (1.47) cm/s2 on day 30. The atrial contribution to total transmitral flow increased significantly from 26 (7)% immediately after conversion of atrial fibrillation to sinus rhythm to 34 (7)% on day 30, indicating the haemodynamic benefit of the restoration of sinus rhythm. Left atrial diameter decreased but not significantly, from 4.11 (0.37) to 3.98 (0.34) cm (P < 0.005). CONCLUSIONS: These results suggest that restoration of atrial mechanical function after pharmacological cardioversion in patients with chronic atrial fibrillation is slow and gradual, as it is after electrical DC restoration of sinus rhythm. This time course may have important implications for determining how long treatment with anticoagulants and antiarrhythmic agents needs to continue in individual patients. It will also influence the clinical assessment of the haemodynamic benefit of restoring sinus rhythm in patients with chronic atrial fibrillation.
Authors:
A Jović; R Troskot
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  77     ISSN:  1355-6037     ISO Abbreviation:  Heart     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-03-11     Completed Date:  1997-03-11     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  46-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Zadar General Hospital, Croatia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Arrhythmia Agents / therapeutic use*
Atrial Fibrillation / drug therapy,  physiopathology,  ultrasonography*
Echocardiography, Doppler, Pulsed*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Contraction*
Quinidine / therapeutic use*
Systole
Time Factors
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 56-54-2/Quinidine
Comments/Corrections

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