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Abstract
We investigated temporary changes in left atrial appendage (LAA) flow velocity patterns
in patients undergoing electrical cardioversion for chronic isolated atrial fibrillation,
and evaluated the role of active LAA contraction in directing blood flow to the left
atrial main chamber and left ventricle. The study consisted of 26 patients with chronic
isolated atrial fibrillation treated with electrical cardioversion and 20 normal controls
in sinus rhythm. Using transthoracic and transesophageal Doppler echocardiography,
we recorded transmitral, pulmonary venous, and LAA flow velocity patterns before,
24 hours, and 1 week after cardioversion in all subjects. In the 15 patients who underwent
successful cardioversion, the maximal LAA area 24 hours after cardioversion was smaller
than the area before cardioversion, whereas LAA ejection fraction during atrial systole
and peak atrial systolic emptying velocity of the LAA flow were lower 24 hours after
cardioversion than those in the control group. One week after cardioversion, maximal
LAA area and LAA peak atrial systolic emptying velocity were restored to levels approximately
equivalent to those in the control group, although LAA ejection fraction was lower
than in the control group. Maximal LAA area and LAA peak atrial systolic emptying
velocity correlated negatively and positively with LAA ejection fraction, respectively,
24 hours and 1 week after cardioversion. These results suggest that LAA and the left
atrial main chamber show stunning 24 hours after cardioversion, and the atrial systolic
emptying wave of LAA flow is generated by active LAA contraction.
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Article Info
Publication History
Accepted:
September 23,
1996
Received:
July 24,
1996
Identification
Copyright
© 1997 Excerpta Medica, Inc. All rights reserved. Published by Elsevier Inc. All rights reserved.
