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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
08:10

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Left atrial dysfunction in patients with atrial fibrillation after successful rhythm control for > 3 months

Yi-Chih Wang1, Jiunn-Lee Lin, Juey-Jen Hwang

  • 1Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.

Chest
|October 21, 2005
PubMed

Insights

Even with controlled heart rhythms, many atrial fibrillation (AF) patients show persistent left atrial (LA) dysfunction. A higher number of stroke risk factors increases the likelihood of this impaired LA function.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Imaging

Background:

  • Clinical trials indicate residual embolic event risk in atrial fibrillation (AF) patients on rhythm-control therapy.
  • Left atrial (LA) dysfunction may persist despite successful maintenance of sinus rhythm for over three months.

Purpose of the Study:

  • To investigate the prevalence and characteristics of left atrial (LA) dysfunction in patients with atrial fibrillation (AF) after achieving satisfactory rhythm control.
  • To identify clinical risk factors associated with persistent LA dysfunction in this patient cohort.

Main Methods:

  • Echocardiography (transthoracic and transesophageal) was performed on 93 AF patients with >3 months of rhythm control.
  • Patients were categorized based on AF type (sustained vs. paroxysmal) and rhythm control method.
  • LA dysfunction was defined by LA appendage (LAA) peak emptying velocity or presence of spontaneous echo contrast/thrombus.

Main Results:

  • Left atrial (LA) dysfunction was identified in 37% (34/93) of patients.
  • Patients with LA dysfunction exhibited larger LA dimensions compared to those without.
  • A higher burden of clinical risk factors (≥3) was significantly associated with LA dysfunction (Odds Ratio 3.1, p=0.04).

Conclusions:

  • Left atrial (LA) dysfunction is prevalent in over one-third of atrial fibrillation (AF) patients even after achieving sustained rhythm control.
  • The presence of multiple clinical risk factors (hypertension, diabetes, etc.) is linked to a greater likelihood of impaired LA function.
Abstract

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