Document Detail


Is left atrial appendage flow a predictor for outcome of cardioversion of nonvalvular atrial fibrillation? A transthroacic and transesophageal echocardiographic study.
MedLine Citation:
PMID:  9351743     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Accurate echocardiographic parameters for predicting the success of cardioversion or maintenance of sinus rhythm are poorly defined. This prospective transthoracic and transesophageal echocardiographic study was conducted to test the hypothesis that the left atrial appendage flow pattern could be a predictive parameter of the success of cardioversion and maintenance of sinus rhythm in patients with nonvalvular atrial fibrillation. Eighty-two consecutive patients with nonvalvular atrial fibrillation of <6 months' duration underwent transesophageal examination after transthoracic echocardiography. After exclusion of left atrial thrombus, pharmacologic (n = 18) or electrical (n = 64) cardioversion was successful in 75 of 82 patients. In the group that underwent successful cardioversion, maintenance of sinus rhythm (n = 35) or recurrence of arrhythmia (n = 40) was assessed during a 1-year follow-up. During transesophageal examination, five left atrial appendage thrombi were found, spontaneous echo contrast was present in 26 (32%) patients, and mean peak left atrial appendage emptying velocity was 35 +/- 18 cm/sec. Peak left atrial appendage emptying velocity was found to be statistically related to parameters of left ventricular and left atrial function but not to long-term maintenance of sinus rhythm. No other echocardiographic parameter was identified as a predictor for either the success of cardioversion or the maintenance of sinus rhythm at follow-up. In patients with nonvalvular atrial fibrillation of recent onset, peak left atrial appendage emptying velocity appears to be a complex parameter depending on left atrial and left ventricular function but that does not predict either the success rate of cardioversion or long-term maintenance of sinus rhythm after successful cardioversion.
Authors:
Y Pérez; A M Duval; C Carville; H Wéber; J C Cachin; A Castaigne; J L Dubois-Randé; P Guéret
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  134     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-11-14     Completed Date:  1997-11-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  745-51     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, University Hospital Henri Mondor, Créteil, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / etiology,  physiopathology*,  therapy,  ultrasonography*
Blood Flow Velocity
Coronary Circulation*
Echocardiography* / methods
Echocardiography, Transesophageal
Electric Countershock*
Female
Heart Atria
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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