Successful cardioversion to sinus rhythm in patients with idiopathic dilated cardiomyopathy significantly improved left ventricular ejection fraction from 32.1% to 52.9% (P<0.001).
Observational (n=17)
Does cardioversion to sinus rhythm improve left ventricular ejection fraction in patients with idiopathic dilated cardiomyopathy and chronic atrial fibrillation?
Successful cardioversion of chronic atrial fibrillation to sinus rhythm significantly improves left ventricular ejection fraction in patients with idiopathic dilated cardiomyopathy.
Absolute Event Rate: 52.9% vs 29.5%
p-value: p=<0.001
To assess the potential improvement in left ventricular ejection fraction after cardioversion of chronic atrial fibrillation to sinus rhythm in idiopathic dilated cardiomyopathy, we studied prospectively 17 patients, aged 58 +/- 6 years, by radionuclide angiocardiography at rest. Left ventricular ejection fraction was determined before treatment and at a mean delay of 4.7 months after cardioversion. Return to sinus rhythm was obtained in 12 patients, pharmacologically or by electrical cardioversion. Five patients remained in atrial fibrillation. No clinical, echocardiographic or haemodynamic finding could predict the success of cardioversion. In chronic atrial fibrillation, the ejection fraction did not change significantly: 30.0 +/- 9.1% (19 to 44%) at the first evaluation and 29.5 +/- 8.3% (22 to 41%) after 4.7 months. After successful cardioversion, left ventricular ejection fraction improved from 32.1 +/- 5.3% (24 to 41%) to 52.9 +/- 9.7% (37 to 71%) (P less than 0.001). The difference was 20.8 +/- 11.3% and left ventricular ejection fraction was normalized in 50% (6/12) of the patients. There was a significant reduction in the cardiothoracic ratio on chest X-rays and of the left ventricular end-diastolic diameter on echocardiography; fractional shortening increased (27.7 +/- 4.3% vs 20.3 +/- 2.7%, P less than 0.01). A third evaluation was realized after a mean delay of 11.7 months in the patients with successful cardioversion. Sinus rhythm was present in 83% (10/12) of the patients: seven patients were reevaluated by radionuclide angiography. The improvement in left ventricular function observed at the 4.7 months evaluation was still present. In two patients with recurrence of atrial fibrillation, there was a severe deterioration of left ventricular systolic function.(ABSTRACT TRUNCATED AT 250 WORDS)
Kieny et al. (Tue,) conducted a observational in chronic atrial fibrillation in idiopathic dilated cardiomyopathy (n=17). Cardioversion to sinus rhythm vs. Remaining in atrial fibrillation was evaluated on Left ventricular ejection fraction (p=<0.001). Successful cardioversion to sinus rhythm in patients with idiopathic dilated cardiomyopathy significantly improved left ventricular ejection fraction from 32.1% to 52.9% (P<0.001).