Key result
Extremely short R-R intervals linked to ~19% lower LAA peak flow velocity vs moderately long intervals.
Why the study?
Does increased heart rate reduce peak flow velocity of the left atrial appendage in patients with nonvalvular atrial fibrillation?
Observational (n=21)
Does increased heart rate reduce peak flow velocity of the left atrial appendage in patients with nonvalvular atrial fibrillation?
Increased heart rate reduces left atrial appendage peak flow velocity in nonvalvular atrial fibrillation, which may promote blood stasis and thrombus formation.
Answers are grounded in this paper and cite their sources.
Short R-R intervals were associated with lower LAA velocity in nonvalvular AF; hypothesis-generating for rate-control effects on stasis and requires prospective confirmation.
BACKGROUND AND HYPOTHESIS: Flow velocity of the left atrial appendage (LAA) is thought to be important in thrombus formation in association with blood stasis and the development of spontaneous echo contrast. The effects of heart rate on peak flow velocity of LAA have not been studied in patients with nonvalvular atrial fibrillation. METHODS: Using transesophageal Doppler echocardiography, peak flow velocity of the LAA was measured at the junction between the left atrium and the LAA during left ventricular (LV) systole and diastole in 21 patients with nonvalvular atrial fibrillation. In six cases, the average peak flow velocity of the LAA for 10 consecutive beats with moderately long R-R intervals (LI beats) was compared with those of 3-5 consecutive beats with extremely short R-R intervals (SI beats). RESULTS: Average peak flow velocity of the LAA during LV diastole was significantly higher than that during LV systole (26.5 +/- 15.7 vs. 19.3 +/- 10.4 cm/s, p < 0.01). In SI beats, average peak flow velocity of the LAA was significantly lower than that in LI beats (17.1 +/- 12.1 vs. 21.2 +/- 12.9 cm/s, p < 0.01). CONCLUSION: An increased heart rate reduced the peak flow velocity of the LAA in patients with nonvalvular atrial fibrillation, which would promote blood stasis in the LAA.
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Noda et al. (1996) conducted an observational in nonvalvular atrial fibrillation (n=21). Extremely short R-R intervals (SI beats) vs. Moderately long R-R intervals (LI beats) was evaluated on Average peak flow velocity of the left atrial appendage (p=<0.01). Extremely short R-R intervals significantly reduced the average peak flow velocity of the left atrial appendage compared to moderately long R-R intervals (17.1 vs 21.2 cm/s; p<0.01).
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