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In patients with chronic atrial fibrillation and left ventricular systolic dysfunction, restoration of sinus rhythm

J Azpitarte1, O Baún, E Moreno

  • 1Division of Cardiology, Virgen de las Nieves University Hospital, Granada, Spain. jazpitarte@lettera.net

Chest
|July 14, 2001
PubMed

Insights

Restoring sinus rhythm (SR) significantly improves left ventricular (LV) function in patients with chronic atrial fibrillation (AF) and LV systolic dysfunction (LVSD). This study shows enhanced LV function and reduced heart rate after successful cardioversion.

Area of Science:

  • Cardiology
  • Cardiac Electrophysiology
  • Heart Failure Research

Background:

  • Chronic atrial fibrillation (AF) with left ventricular systolic dysfunction (LVSD) presents a significant clinical challenge.
  • Optimizing treatment strategies for these patients is crucial for improving cardiac function and patient outcomes.

Purpose of the Study:

  • To evaluate the therapeutic benefit of restoring sinus rhythm (SR) in patients diagnosed with chronic, rate-controlled AF and underlying LVSD.
  • To assess the impact of SR restoration on echocardiographic and clinical parameters.

Main Methods:

  • A prospective case-control study was conducted involving 20 patients with chronic AF and LVSD (LVFS < 28%).
  • Attempted cardioversion to restore SR was performed using amiodarone or electrical countershock.
  • Outcomes were evaluated over 6-9 months, comparing patients with sustained SR to a control group.

Main Results:

  • Successful SR restoration was achieved in 17 patients, with sustained SR in 13.
  • Sustained SR significantly improved left ventricular fractional shortening (LVFS) from 20% to 31% (p < 0.0001).
  • Associated improvements included reduced LV end-diastolic dimension, LV mass, left atrial diameter, heart rate, and NYHA functional class.

Conclusions:

  • Restoration and maintenance of SR significantly enhance left ventricular function in patients with chronic AF and LVSD, even with prior rate control.
  • These findings underscore the importance of rhythm control strategies in managing AF-related heart dysfunction.
Abstract

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