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Related Experiment Videos

Left atrial mechanical function after brief duration atrial fibrillation

P B Sparks1, S Jayaprakash, H G Mond

  • 1Royal Melbourne Hospital Department of Cardiology, University of Melbourne, Parkville, Victoria, Australia.

Journal of the American College of Cardiology
|February 11, 1999
PubMed
Summary

Brief atrial fibrillation (AF) in patients with structural heart disease did not cause significant left atrial stunning. Spontaneous echo contrast (SEC) during AF resolved quickly upon rhythm reversion, suggesting a low thromboembolism risk.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Mechanics

Background:

  • Left atrial dysfunction and spontaneous echo contrast (SEC) can follow cardioversion of atrial fibrillation (AF) to sinus rhythm, a phenomenon termed "stunning."
  • This "stunning" is implicated in atrial thrombus formation and embolic stroke.
  • The impact of brief AF on left atrial mechanical function in humans remains unclear.

Purpose of the Study:

  • To investigate the effects of brief, induced atrial fibrillation on left atrial and left atrial appendage mechanical function.
  • To assess the occurrence and resolution of spontaneous echo contrast (SEC) following AF in patients with structural heart disease.

Main Methods:

  • Transesophageal echocardiography was used to evaluate left atrial appendage emptying velocities (LAAeV) and SEC in 24 patients with structural heart disease.

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  • Atrial fibrillation was induced for 15 minutes via rapid right atrial pacing, with assessments performed before, during, and after AF termination (spontaneous or DC shock).

    • Main Results:

    • No significant reduction in LAAeV (>20%), indicative of atrial stunning, was observed post-AF.
    • SEC developed in 58% of patients during AF but resolved rapidly within 30 seconds of sinus rhythm restoration.
    • LAAeV did not differ significantly between patients with spontaneous AF termination and those requiring DC cardioversion.

    Conclusions:

    • Brief duration atrial fibrillation does not appear to cause significant left atrial stunning in patients with structural heart disease.
    • Transient SEC during AF resolves quickly, suggesting a potentially low risk of thromboembolism even in this patient group.
    • Findings have implications for patients with implantable devices capable of atrial defibrillation.