Serial evaluation of left atrial dimension after cardioversion for atrial fibrillation and relation to atrial function
Section snippets
Study population
Hemodynamically stable patients referred for cardioversion for nonrheumatic AF between September 1997 and December 1998 were considered for inclusion in this study. The study group included 171 consecutive patients; 15 were excluded because they did not meet the inclusion criteria. Fifty-six patients had spontaneous recovery of sinus rhythm and the remaining 100 patients were randomized to receive intravenous procainamide or electrical cardioversion. Patients were excluded from the study if
Results
Before intravenous therapy, 56 patients had spontaneous conversion to sinus rhythm (group A). Of the remaining 100 patients, 50 patients were randomized to DC shock and 50 were randomized to receive procainamide. Elective cardioversion for AF was accomplished pharmacologically in 32 patients (64%; group B) and with DC cardioversion in 48 patients (96%; group C). The 3 groups were similar with respect to age and concomitant diseases; the duration of AF was significantly shorter in the group of
Discussion
The present study evaluated the recovery of atrial mechanical function after cardioversion for AF and its relation with LA volumes and function. One conclusion that emerged from the present study was that LA mechanical function was impaired after atrial defibrillation, and recovery was delayed in patients who underwent DC shock compared with patients who spontaneously reverted or who underwent pharmacologic cardioversion. These data confirm previous results from other studies.10, 14 Recovery
References (24)
- et al.
Atrial fibrillation and atrial enlargement in patients with mitral stenosis
Am Heart J
(1987) - et al.
Left atrial diameter in nonvalvular atrial fibrillationan echocardiographic study
Am Heart J
(1999) - et al.
Atrial ejection force. A noninvasive assessment of atrial systolic function
J Am Coll Cardiol
(1993) - et al.
Clinical and echocardiographic features influencing recovery of atrial function after cardioversion of atrial fibrillation
Am J Cardiol
(1998) - et al.
Two-dimensional echocardiographic determination of left atrial emptying volumea non invasive index in quantifying the degree of nonrheumatic mitral regurgitation
J Am Coll Cardiol
(1983) - et al.
Echocardiographic features of left atrium in elite male athletes
Am J Cardiol
(1996) - et al.
Temporal dependence of the return of atrial mechanical function on the mode of cardioversion of atrial fibrillation to sinus rhythm
Am J Cardiol
(1995) - et al.
Impaired left atrial mechanical function after cardioversionrelation to the duration of atrial fibrillation
J Am Coll Cardiol
(1994) - et al.
Mechanical dysfunction of the left atrium and the left atrial appendage following cardioversion of atrial fibrillation and its relation to total electrical energy used for cardioversion
Am J Cardiol
(1998) - et al.
Evaluation of left atrial appendage anatomy and function in recent-onset atrial fibrillation by transesophageal echocardiography
Am J Cardiol
(1996)
A comparison of the effects of A. C. and D. C. countershock on ventricular function in thoracotomized dogs
Am J Cardiol
Left atrial mechanical function after brief duration atrial fibrillation
J Am Coll Cardiol
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2021, JACC: Basic to Translational ScienceCitation Excerpt :LA volume (LAV) and LA area were calculated as described in humans (23) from a right parasternal long-axis view, using the Simpson’s rule at end-systole and end-diastole. LA function, assessed by LA volumes, was calculated according to atrial function studies in humans (24). Changes in LAV expressed as ejection fraction (LA-EF = [LAVmax − LAVmin]/LAVmax) (25).
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2009, JACC: Cardiovascular InterventionsCitation Excerpt :This amount accounts for 35% of LA flow (23). The booster pump function represents LA contraction and is dependent on several factors, including timing of atrial systole, vagal stimulation, magnitude of venous return, left ventricular end-diastolic pressures, and left ventricular systolic reserve (24). On the basis of these considerations, it is likely that some degree of LA dysfunction, such as impairment of active or passive emptying or perhaps conduit function, might be present in patients with PFO, especially those with moderate-large ASA.