[Changes of echocardiographic data in auricular fibrillation of patients with rheumatic mitral valve defect]

Echocardiography was employed in 39 patients with rheumatic mitral valve disease and atrial fibrillation prior to and following electric defibrillation. Patients under 60 years of age, mainly those subjected to a surgical correction of the disease, with a history of fibrillation under 3 years and without signs of thromboembolic complications in the past were selected for sinus rhythm restoration. The peculiarities of echocardiograms in different frequency of the ventricular rhythm are described. A correlation was found between the end diastolic and stroke volumes and the duration of the diastole in the preceeding cycle. The relationship of the ejection fraction and of the heart contractions rate was demonstrated: in sudden rhythm accelerations in 2 successive cycles the ejection fraction decreases in the 3rd cycle, and in sudden rhythm decelerations it increases. The echocardiographic manifestations of mechanically ineffective systoles are described. Sinus rhythm was restored by defibrillation in 80% of the cases. The haemodynamic parameters prior to and following the elimination of cardiac fibrillation are presented. It is concluded that an echocardiographic enlargement of the left atrium over 60 mm is an unfavourable prognostic sign for sinus rhythm restoration.