Transesophageal echocardiographic evaluation of left atrial appendage function and spontaneous contrast formation after chemical or electrical cardioversion of atrial fibrillation. 1996

R A Falcone, and F Morady, and W F Armstrong
University of Michigan Hospital, Ann Arbor, USA.

Changes in left atrial (LA) appendage pulsed-wave Doppler velocities and changes in grades of spontaneous contrast occur immediately after electrical cardioversion of atrial fibrillation (AF) using transesophageal echocardiography (TEE). The effect of sequential ineffective electrical cardioversion attempts or chemical cardioversion on these parameters is unknown. TEE was performed in 23 patients with chronic AF. Doppler velocities and grades of spontaneous contrast were assessed before and after each cardioversion attempt until sinus rhythm was achieved. Doppler emptying and filling velocities were significantly decreased after electrical (0.39 +/- 0.14 vs 0.27 +/- 0.16 [p = 0.01] and 0.43 +/- 0. 18 vs 0.30 +/- 0.14 m/s [p = 0.01]) or chemical cardioversion to sinus rhythm (0.65 +/- 0.18 vs 0.31 +/- 0.06 [p = 0.03] and 0.64 +/- 0.22 vs 0.44 +/- 0.17 m/s [p = 0.04]). Spontaneous contrast developed in 1 of 3 patients after chemical conversion to sinus rhythm and was present in 11 of 20 patients before electrical cardioversion, developing in 4 patients and intensifying in 2 patients immediately after successful cardioversion. These phenomena were not seen after ineffective electrical or chemical cardioversion attempts. This suggests that restoration of sinus rhythm is in itself responsible for these phenomena, not the method by which sinus rhythm is achieved.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009200 Myocardial Contraction Contractile activity of the MYOCARDIUM. Heart Contractility,Inotropism, Cardiac,Cardiac Inotropism,Cardiac Inotropisms,Contractilities, Heart,Contractility, Heart,Contraction, Myocardial,Contractions, Myocardial,Heart Contractilities,Inotropisms, Cardiac,Myocardial Contractions
D001783 Blood Flow Velocity A value equal to the total volume flow divided by the cross-sectional area of the vascular bed. Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D002302 Cardiac Output The volume of BLOOD passing through the HEART per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with STROKE VOLUME (volume per beat). Cardiac Outputs,Output, Cardiac,Outputs, Cardiac
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D003287 Contrast Media Substances used to allow enhanced visualization of tissues. Radiopaque Media,Contrast Agent,Contrast Agents,Contrast Material,Contrast Materials,Radiocontrast Agent,Radiocontrast Agents,Radiocontrast Media,Agent, Contrast,Agent, Radiocontrast,Agents, Contrast,Agents, Radiocontrast,Material, Contrast,Materials, Contrast,Media, Contrast,Media, Radiocontrast,Media, Radiopaque
D004077 Digoxin A cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone DIGOXIGENIN. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in ATRIAL FIBRILLATION and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666) Digacin,Digitek,Digoregen,Digoxina Boehringer,Digoxine Nativelle,Dilanacin,Hemigoxine Nativelle,Lanacordin,Lanicor,Lanoxicaps,Lanoxin,Lanoxin-PG,Lenoxin,Mapluxin,Boehringer, Digoxina,Lanoxin PG,Nativelle, Digoxine,Nativelle, Hemigoxine
D004554 Electric Countershock An electrical current applied to the HEART to terminate a CARDIAC ARRHYTHMIA. Cardiac Electroversion,Cardioversion,Defibrillation, Electric,Electroversion, Cardiac,Electrical Cardioversion,Electroversion Therapy,Therapy, Electroversion,Cardiac Electroversions,Cardioversion, Electrical,Cardioversions,Cardioversions, Electrical,Countershock, Electric,Countershocks, Electric,Defibrillations, Electric,Electric Countershocks,Electric Defibrillation,Electric Defibrillations,Electrical Cardioversions,Electroversion Therapies,Electroversions, Cardiac,Therapies, Electroversion
D005260 Female Females

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