Left atrial and left ventricular function following cardioversion of atrial fibrillation. An echocardiographic study.

Abstract

In view the adverse consequence of AF comprising hemodynamic deterioration, I risk of thromboembolic complications beside the intolerable fast palpitation, I cardioverting AF to sinus rhythm is an ideal goal. There had been some controversy t concerning the effect of AF on atrial dimensions and functions. Furthermore the need for long term warfarin anticoagulation prior to cardioversion is still on doubt. The present work addresses the latter 2 issues through studying 54 patients (27 females and 27 males, mean age 54 years, aged from 23 to 74 years). Underlying cardiac examination revealed rheumatic heart disease in 23 pts, hypertension in 19 pts, ischemic heart disease in 7 pts, lone AF in 3 pts only one pt had cardiomyopathy, and one pt had thyrotoxicosis. Prior to cardioversion all patients were subjected to clinical evaluation, transthoracic (TTE), transesophageal echocardiography were done only in 7 pts (TEE) and heparin or warfarin anticoagulation for at least 14 days, Standard M­ mode, cross sectional and pulsed Doppler echocardiography were obtained using Hewlett-Packard Sonos 1000. Echo parameters measured before cardioversion compared LVEDD, LVESD, FS, left atrial dimensions (length, diameter and volume by planimetry). Left atrial function after eardioversion expressed as atrial ejection force (AEF), and Doppler A-wave after cardioversion. the presence of LA thrombus or spontaneous echo contrast (SEC) were studied by TIE or TEE. Measures were recorded 2 weeks after cardioversion to avoid LA stunning.