Serial evaluation of left atrial dimension after cardioversion for atrial fibrillation and relation to atrial function

• Published in: The American journal of cardiology 2000-04, Vol.85 (7), p.832-836
• Main Authors: Mattioli, Anna Vittoria, Sansoni, Stefania, Lucchi, Giulia Ricci, Mattioli, Giorgio
• Format: Article
• Language: English
• Subjects: Aged; Anti-Arrhythmia Agents - administration & dosage; Anti-Arrhythmia Agents - therapeutic use; Atrial Fibrillation - physiopathology; Atrial Fibrillation - therapy; Atrial Function, Left - physiology; Biological and medical sciences; Diseases of the cardiovascular system; Echocardiography, Doppler, Color; Electric Countershock; Female; Heart Atria - diagnostic imaging; Heart Atria - physiopathology; Heart Rate; Humans; Injections, Intravenous; Male; Medical sciences; Middle Aged; Procainamide - administration & dosage; Procainamide - therapeutic use; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Retrospective Studies; Treatment Outcome
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(99)00876-0

The size of the left atrium is usually increased during atrial fibrillation (AF). The aim of the present study was to evaluate changes in left atrial (LA) dimension after cardioversion for AF, and the relation between LA dimension and atrial function. The initial study population included 171 consecutive patients. Patients who had spontaneous cardioversion to sinus rhythm (56 patients) were compared with patients who had random cardioversion with drugs (50 patients) or direct-current (DC) shock (50 patients). Echocardiographic evaluations included LA size and volume. LA passive and active emptying volumes were calculated, and LA function was assessed. Atrial stunning was observed in 18 patients reverted with DC shock and in 7 patients reverted with drugs. The left atrium was dilated in all patients during AF (48 ± 5 mm). The size of the left atrium decreased after restoration of sinus rhythm in all patients with spontaneous reversion to sinus rhythm, in 73% of patients reverted with drugs, and in 50% of patients reverted with DC shock. The comparison between patients with a normal mechanical atrial function and patients with reduced atrial function showed that a higher atrial ejection force was associated with a more marked reduction in LA size after restoration of sinus rhythm. A relation between LA volumes and atrial ejection force was observed in the group of patients with depressed atrial mechanical function (r = −0.78; p