Elective direct current cardioversion of atrial fibrillation was followed by a gradual recovery of atrial mechanical function, returning to normal control values at 3 weeks (p<0.005).
Observational (n=21)
Does left atrial mechanical function recover immediately after electrical cardioversion of atrial fibrillation?
Left atrial mechanical function takes at least 3 weeks to return to normal after successful electrical cardioversion of atrial fibrillation, supporting the need for continued anticoagulation during this vulnerable period.
p-value: p=<0.005
Full recovery of atrial mechanical activity may not occur immediately after successful electrical cardioversion of atrial fibrillation to sinus rhythm. To examine the time course of recovery of left atrial mechanical function, serial two-dimensional, M-mode and transmitral pulsed Doppler echocardiographic studies were performed in 21 patients after elective direct current cardioversion of atrial fibrillation of 3 weeks' to 24 months' duration (mean 5 months). Over 3 months of follow-up, there were significant increases in both peak A wave velocity (p less than 0.005) and percent atrial contribution to total left ventricular filling (p less than 0.005). Compared with values in a normal control population, peak A wave velocity and percent atrial contribution to total left ventricular filling did not return to normal until 3 weeks after cardioversion in patients who remained in sinus rhythm. Left atrial dimension also decreased over the follow-up period (p less than 0.05) in patients with persistent sinus rhythm. These results may have important implications in guiding the appropriate duration of anticoagulant therapy after cardioversion, and in clinically assessing the hemodynamic benefit of restoring sinus rhythm in an individual patient.
Manning et al. (1989) conducted an observational in Atrial fibrillation (n=21). Elective direct current cardioversion vs. Normal control population was evaluated on Peak A wave velocity and percent atrial contribution to total left ventricular filling (p=<0.005). Elective direct current cardioversion of atrial fibrillation was followed by a gradual recovery of atrial mechanical function, returning to normal control values at 3 weeks (p<0.005).