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Acute changes in spontaneous echo contrast and atrial function after cardioversion of persistent atrial flutter
R Weiss1, P Marcovitz, B P Knight
1Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0022, USA.
The American Journal of Cardiology
|November 17, 1998
Summary
Electrical cardioversion for atrial flutter (AFI) can cause temporary atrial stunning and spontaneous echo contrast. Some patients with persistent AFI may have left atrial thrombi before cardioversion.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Persistent atrial flutter (AFI) poses risks, including potential thrombus formation.
- Understanding the immediate effects of cardioversion on atrial function is crucial for patient management.
Purpose of the Study:
- To evaluate the short-term impact of transthoracic electrical cardioversion on atrial mechanical function and spontaneous echo contrast in patients with AFI.
- To assess left atrial appendage emptying velocity and spontaneous echo contrast post-cardioversion.
Main Methods:
- Transesophageal echocardiography was used to assess 30 patients undergoing transthoracic electrical cardioversion for AFI.
- Left atrial appendage emptying velocity and spontaneous echo contrast were measured immediately before and at serial intervals up to 15 minutes after cardioversion.
Main Results:
- Cardioversion was deferred in 7% of patients due to detected left atrial appendage thrombi.
- A significant decrease (26%) in left atrial appendage emptying velocity was observed 1 minute post-cardioversion (p <0.01).
- New or worsened spontaneous echo contrast developed in 43% of patients within 5 minutes after achieving sinus rhythm.
Conclusions:
- Persistent AFI may be linked to the presence of left atrial thrombi prior to cardioversion.
- Transthoracic electrical cardioversion of AFI results in significant atrial stunning and the formation of spontaneous echo contrast.