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Acute reductions in ventricular myocardial tissue velocities after direct current cardioversion of atrial

Kevin C Fung1, Hiok C Tan, Leonard Kritharides

  • 1Department of Cardiology, University of Sydney, Concord Hospital, Hospital Road, Concord, NSW 2139, Australia.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|June 5, 2003
PubMed

Insights

Direct current (DC) cardioversion acutely reduces left ventricular velocity in patients with atrial fibrillation. This effect is reversible and subclinical, warranting further investigation into its clinical significance.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Echocardiography

Background:

  • Direct current (DC) cardioversion can cause atrial stunning.
  • Acute pulmonary edema is a reported complication of DC cardioversion.
  • The impact of DC cardioversion on ventricular function is not well understood.

Purpose of the Study:

  • To investigate the acute effects of DC cardioversion on myocardial velocity.
  • To assess ventricular dysfunction using Doppler tissue imaging after DC cardioversion.

Main Methods:

  • 40 patients (30 with atrial fibrillation, 10 with atrial flutter) underwent transthoracic echocardiography.
  • Doppler tissue imaging assessed peak systolic velocity in 6 ventricular segments before and after DC cardioversion.
  • Follow-up assessments were conducted after achieving sustained sinus rhythm.

Main Results:

  • DC cardioversion significantly decreased peak systolic velocity in multiple ventricular segments in patients with atrial fibrillation.
  • Left ventricular ejection fraction remained unchanged immediately after DC cardioversion.
  • No significant changes in peak systolic velocity were observed in the atrial flutter group; all patients showed improved velocity upon follow-up.

Conclusions:

  • DC cardioversion induces a subclinical, acute, and reversible reduction in left ventricular peak systolic velocity in atrial fibrillation patients.
  • The clinical significance and underlying mechanisms of this reduction require further study.
Abstract

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