Haemodynamic studies before and after electrical conversion of atrial fibrillation and flutter to sinus rhythm.

Resnekov, Leon

doi:10.1136/hrt.29.5.700

Cited by 51 publications

(11 citation statements)

References 37 publications

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“…In a study by Scott and Patterson [2], heart rate at rest remained unchanged immediately after car dioversion, but increased significantly 3 days later. Resnekov [3] found a significant increase in cardiac output during exercise after restoration of normal sinus rhythm.…”

Section: Invasive Evaluation O F Atrial Mechanical Function After Carmentioning

confidence: 99%

“…The restoration of sinus rhythm is not always accom panied by a return of normal atrial mechanical function, as has been demonstrated by invasive and noninvasive studies [2][3][4]. In order to determine whether there is a delay in atrial contraction following the return of sinus KARGER rhythm, we studied the mitral pattern with Doppler echo cardiography.…”

Section: Introductionmentioning

confidence: 99%

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Restoration of Atrial Function after Atrial Fibrillation of Different Etiological Origins

et al. 1996

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In order to evaluate atrial function after the restoration of normal sinus rhythm in patients with atrial fibrillation, an echocardiographic study was performed in 60 patients hospitalized for atrial fibrillation that was subsequently converted to sinus rhythm. The study population consisted of 60 patients, 41 males and 19 females, with a mean age of 67 ± 8 years. In etiological terms, 20 patients had atrial fibrillation with no associated pathology, 20 had an underlying ischemic cardiopathy an 20 had hypertension. The duration of atrial fibrillation varied from 24 h to 6 months. The restoration of sinus rhythm was spontaneous in 20 patients and drug induced in 40. Patients were divided into groups on the basis of the duration of the atrial fibrillation, the etiology of the atrial fibrillation and the size of the atrium. Transmitral Doppler inflow patterns at rest were assessed within 24 h after conversion to sinus rhythm, and 1 week, 1 month and 3 months later. The statistical significance of serial changes in peak A velocity and A wave integral was determined by analysis of variance. Using the peak A wave for atrial filling and the velocity-time integral as the index of atrial mechanical function, the following results were obtained: restoration of atrial mechanical function occurred earlier in hypertensive patients and in patients with atrial fibrillation only than in patients with associated ischemic cardiopathy. Restoration also occurred earlier in the group of patients that had atrial fibrillation for < 24 h and in patients whose left atrium was of normal size. Since the mechanical activity of the left atrium, evaluated as the peak A wave, does not necessarily return immediately after the restoration of sinus rhythm, a follow-up assessment of the contraction of the left atrium is appropriate.

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Section: Invasive Evaluation O F Atrial Mechanical Function After Carmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Restoration of Atrial Function after Atrial Fibrillation of Different Etiological Origins

et al. 1996

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“…[1][2][3][4][5][6]8 Upshaw reported the hemodynamic aspects and possible causes of this phenomenon; he observed that cardiac output decreased after cardioversion in more than one-third of the patients, and it took more than 4 weeks to gradually increase. 1 One of the causes of this delayed recovery is considered to be the gradual recovery of atrial function, in particular, delayed recovery of left atrial function compared with that of the right.…”

Section: Discussionmentioning

confidence: 99%

“…here have been previous cases of left-sided heart failure soon after successful electrical cardioversion, [1][2][3][4][5][6][7][8] but the mechanism of this curious phenomenon has not yet been clarified completely. One possible cause is that left atrial mechanical activity recovers much more slowly than that of the right atrium.…”

mentioning

confidence: 99%

Restrictive Cardiomyopathy With Right-Sided Dominant Heart Failure After Sinus Conversion From Atrial Fibrillation-Case Report-

Sasaki

Yasumura

Uemura

et al. 2003

Circ J

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here have been previous cases of left-sided heart failure soon after successful electrical cardioversion, 1-8 but the mechanism of this curious phenomenon has not yet been clarified completely. One possible cause is that left atrial mechanical activity recovers much more slowly than that of the right atrium. 1 The underlying cardiovascular disorders of these patients were rheumatic heart disease, hypertrophic cardiomyopathy, ischemic heart disease, and congenital heart disease. We present an intriguing case of restrictive cardiomyopathy that developed right-sided dominant heart failure whenever atrial fibrillation (AF) was converted to sinus rhythm spontaneously or by electrical cardioversion. We report the interesting hemodynamic profile during both AF and sinus rhythm that suggests the possible mechanism of right-sided heart failure, and the therapy that has successfully controlled recurrence of heart failure in this patient. Case ReportA 44-year-old woman was referred to hospital in March, 2000 complaining of palpitation, heaviness in the right upper quadrant and dyspnea on exertion after a palpitation. She had had some cardiac disease diagnosed by her home doctor at 16 years of age, and had experienced occasional palpitations thereafter. At 38 years old, she sometimes felt a heaviness in the right upper quadrant, and had dyspnea when she tried to continue her work in this condition. At 40 years old, the frequency of the palpitation attacks increased Circulation Journal Vol.67, November 2003and she was diagnosed as paroxysmal AF the next year. Medication did not control the symptoms. When the AF was converted to sinus rhythm, the feeling of heaviness in the right upper quadrant developed, with a significant increase in hepatic enzymes. In contrast, these symptoms improved during AF. The patient had also had hypothyroidism since the age of 40 years, but had become euthyroid without medication. Her mother also had had AF since the age of 40 years and after one episode of cardiac failure, she was diagnosed as cardiomyopathy.On admission, the present patient's height was 147 cm, and her weight was 53 kg. Her blood pressure was 106/66 mmHg and the pulse rate was 125 beats/min and irregular. The third heart sound was audible. The liver was palpable with tenderness 2 fingerbreadths below the xiphoid process. There was no apparent edema and her palpebral conjunctivae were not anemic.Chest X-ray revealed a cardiothoracic ratio of 60% and mild lung congestion (Fig 1). The ECG showed atrial flutter -fibrillation at a heart rate 143 beats/min with incomplete right bundle branch block and evident left ventricular hypertrophy (Fig 1).Laboratory tests revealed elevated hepatic enzymes (aspartate aminotransferase 59 U/L, alanine aminotransferase 79 U/L, -glutamyl transpeptidase 79 U/L), possibly because of liver congestion, and serum atrial natriuretic peptide (ANP) (200 pg/ml) and brain natriuretic peptide (BNP) (657 pg/ml) concentrations were also increased. Serum thyroid stimulating hormone (TSH) was mildly elevated (free...

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“…D C shock treatment has been a safe and effective method for achieving sinus rhythm in cases of atrial fibrillation. The long-term results, however, have on the whole been more or less disappointing according to several reports (6, 7, 9, 10, 1 1 , 12, 16,17,20,22). Uncertainty as t o the value of this treatment in thc long-term management of the arrhythmia has succeeded early enthusiasm for DC shock as a means of restoring sinus rhythm in patients with atrial fibrillation.…”

mentioning

confidence: 99%

Factors Influencing Persistence of Sinus Rhythm After Dc Shock Treatment of Atrial Fibrillation

Waris

Kreus

Salokannel

1971

Journal of Internal Medicine

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Abstract. Of 164 patients with atrial fibrillation, 87% were converted to sinus rhythm, but 51 (32%) of them reverted to atrial fibrillation during the next four days. Of the patients with a successful conversion 41 % were still in sinus rhythm after three months, 34% after six months, and 13.4 % after 12 months. Factors which had a favourable influence on the long‐term results were: 1) a less than 2‐year duration of atrial fibrillation preceding the treatment; 2) age of patients less than 50 years; 3) a normal size of heart; and 4) the hypertensive or hyperthyroid etiology of the underlying heart disease. Pretreatment with quinidine before the DC shock was of no value, and the late results were not significantly better in the quinidine‐treated group than in the controls.

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Haemodynamic studies before and after electrical conversion of atrial fibrillation and flutter to sinus rhythm.

Cited by 51 publications

References 37 publications

Restoration of Atrial Function after Atrial Fibrillation of Different Etiological Origins

Restoration of Atrial Function after Atrial Fibrillation of Different Etiological Origins

Restrictive Cardiomyopathy With Right-Sided Dominant Heart Failure After Sinus Conversion From Atrial Fibrillation-Case Report-

Factors Influencing Persistence of Sinus Rhythm After Dc Shock Treatment of Atrial Fibrillation

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