Impaired Atrial Contraction in Patients With Atrial Flutter and Gradual Recovery After Cardioversion

Impaired Atrial Contraction in Patients With Atrial Flutter and Gradual Recovery After Cardioversion

The risk of thromboembolism after cardioversion of atrial flutter is controversial. The present study provides evidence for blood stasis in the atria of patients with atrial flutter and for gradual recovery of atrial contraction after cardioversion, which justifies prophylactic treatment at cardiove...

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Bibliographic Details
Published in:JAPANESE CIRCULATION JOURNAL Vol. 62; no. 1; pp. 15 - 20
Main Authors: Kobayashi, Nobuhiko, Kasahara, Miho, Kasahara, Hiroshi, Ushimaru, Hiroyasu, Ochi, Tomio, Saito, Muneyasu, Yaginuma, Toshio
Format: Journal Article
Language:English
Published: Kyoto The Japanese Circulation Society 1998
Japanese Circulation Society
Subjects:
Aged
Atrial contraction
Atrial flutter
Atrial Flutter - physiopathology
Atrial Function - physiology
Biological and medical sciences
Cardiac dysrhythmias
Cardiology. Vascular system
Cardioversion
Echocardiography, Transesophageal
Electric Countershock
Female
Heart
Humans
Male
Medical sciences
Middle Aged
Myocardial Contraction - physiology
Thromboembolism
Sonography
Human
Intensive cardiocirculatory care
Cardiac performance
Echocardiography
Prognosis
Arrhythmia
Instrumentation therapy
Cardiovascular disease
Cardioversion
Left atrium
Excitability disorder
Atrial flutter
Vascular disease
Treatment
Heart disease
Thromboembolism
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Summary:The risk of thromboembolism after cardioversion of atrial flutter is controversial. The present study provides evidence for blood stasis in the atria of patients with atrial flutter and for gradual recovery of atrial contraction after cardioversion, which justifies prophylactic treatment at cardioversion, as for atrial fibrillation. We examined atrial thrombi and peak flow velocity in the left atrial appendage as an index of blood stasis in 5 consecutive patients with atrial flutter. Transesophageal echocardiography revealed a thrombus in 1 patient, and peak flow velocity in the left atrial appendage was inversely correlated with left atrial dimension (r=-0.90, p<0.05). After restoration of sinus rhythm, transmitral flow velocity in late diastole was also examined to evaluate the recovery of atrial contraction. The recovery of transmitral flow velocity the next day and 1 week after cardioversion was correlated with flow velocity in the left atrial appendage before cardioversion (r=0.89, p<0.05; r=0.97, p<0.01, respectively). These findings suggest that some patients with atrial flutter have impaired atrial contraction and that prolonged impairment after cardioversion is also possible. Atrial enlargement and low flow velocity in the atrial appendage were predictive factors for such patients. (Jpn Circ J 1998; 62: 15 - 20)
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ISSN:0047-1828
1347-4839
DOI:10.1253/jcj.62.15