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Hemodynamic Effects of Cardioversion in Chronic Atrial Fibrillation: Special Reference to Coronary Artery Disease

Hemodynamic Effects of Cardioversion in Chronic Atrial Fibrillation: Special Reference to... Abstract The hemodynamic effects of conversion in chronic atrial fibrillation (AF) were studied in eight patients with coronary artery disease (CAD) (group 1) and five patients with AF of varied etiology (group 2). The resting stroke index (SI) in group 1 increased from 28.3 ml/sq m to 34.6 ml/sq m (P <.05) 30 minutes after conversion but the other parameters did not change. In patients who maintained normal sinus rhythm (NSR) three weeks following cardioversion the response to exercise was improved, with lower heart rate and higher cardiac index (CI), SI, and stroke work (SW). In relating filling pressures to SW, ventricular function was improved with NSR. Right atrial a waves returned simultaneously with NSR in 75% of patients whereas left atrial a waves appeared in 55%. Patients who failed to develop left atrial a waves immediately after cardioversion reverted to AF within three weeks. References 1. Lown B, Amarsingham R, Newman J: New method for terminating cardiac arrhythmias: Use of synchronized capacitor discharge. JAMA 182:548-555, 1962.Crossref 2. Hurst JW, Paulk EA Jr, Proctor HD, et al: Management of patients with atrial fibrillation. Amer J Med 37:728-741, 1964.Crossref 3. Killip T, Baer RA: Hemodynamic effects after reversion from atrial fibrillation to sinus rhythm by precordial shock. J Clin Invest 45:658-671, 1966.Crossref 4. Lown B: Electrical reversion of cardiac arrhythmias. Brit Heart J 29:469-488, 1967.Crossref 5. Mitchell JH, Gilmore JP, Sarnoff SJ: The transport function of the atrium: Factors influencing the relationship between mean left atrial pressure and left ventricular enddiastolic pressure. Amer J Cardiol 9:237-247, 1962.Crossref 6. Skinner N, Mitchell JH, Wallace AG, et al: Hemodynamic effects of altering the timing of atrial systole. Amer J Physiol 205:499-503, 1963. 7. Braunwald E: Symposium on cardiac arrhythmias: Introduction with comments on the hemodynamic significance of atrial systole. Amer J Med 37:665-669, 1964.Crossref 8. Mitchell JH, Gupta DN, Payne RM: Influence of atrial systole on effective ventricular stroke volume. Circ Res 17:11-18, 1965.Crossref 9. Samet P, Bernstein W, Levine S: Significance of atrial contribution to ventricular filling. Amer J Cardiol 15:195-202, 1965.Crossref 10. Ruskin J, Harley A, Rembert J, et al: Contribution of atrial systole to ventricular stroke volume in man. Circulation 38( (suppl 6) ):168, 1968.Crossref 11. Leinbach RC, Chamberlin DA, Kastor JA, et al: A comparison of the hemodynamic effects of ventricular and sequential AV pacing in patients with heart block. Amer Heart J 78:502-508, 1969.Crossref 12. Ruskin J, McHale PA, Harley A, et al: Pressure flow studies in man: Effect of atrial systole on left ventricular function. J Clin Invest 49:472-478, 1970.Crossref 13. Grettinger JS, Carleton RA, Muenster JJ: Circulatory consequences of changes in cardiac rhythm produced in patients by transthoracic direct current shock. J Clin Invest 43:2290-2302, 1964.Crossref 14. Duchelle RA: Indications for conversion of atrial fibrillation to normal sinus rhythm. Med Clin N Amer 50:117-125, 1966. 15. Morris JJ Jr, Entman M, North WC, et al: The changes in cardiac output with reversion of atrial fibrillation to sinus rhythm. Circulation 31:670-678, 1965.Crossref 16. Reale A: Acute effects of countershock conversion of atrial fibrillation upon right and left heart hemodynamics. Circulation 32:214-222, 1965.Crossref 17. Kahn DR, Kirsch MM, Ferguson PW, et al: Cardioversion after mitral valve operations. Circulation 35( (suppl 1) ):82-85, 1967.Crossref 18. Kaplan MA, Gray RE, Iseri LT: Metabolic and hemodynamic responses to exercise during atrial fibrillation and sinus rhythm. Amer J Cardiol 22:543-549, 1968.Crossref 19. Shapiro W, Kline G: Alterations in cardiac function immediately following electrical conversion of atrial fibrillation to normal sinus rhythm. Circulation 38:1074-1084, 1968.Crossref 20. Logan WF, Rollands WE, Howitt DJ, et al: Left atrial activity following cardioversion. Lancet 2:471-473, 1965.Crossref 21. Ikram H, Nixon PGF, Arcan T: Left atrial function after electrical conversions to sinus rhythm. Brit Heart J 30:80-83, 1968.Crossref 22. Oram S, Davies JPH, Weinbren I, et al: Conversion of atrial fibrillation to sinus rhythm by D.C. shock. Lancet 2:159-162, 1963.Crossref 23. Scott ME, Patterson GC: Cardiac output after direct current conversion of atrial fibrillation. Brit Heart J 31:87-90, 1969.Crossref 24. Ikram H, Nixon PGF, Arcan T: Direct current countershock for atrial fibrillation. Lancet 2:911, 1966.Crossref 25. Lindsay J: Pulmonary edema following cardioversion. Amer Heart J 74:434-435, 1967.Crossref 26. Halmos PB: Direct current conversion of atrial fibrillation. Brit Heart J 28:302-308, 1966.Crossref 27. Hall JI, Wood DR: Factors affecting cardioversion of atrial arrhythmias with special reference to quinidine. Brit Heart J 30:84-90, 1968.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Hemodynamic Effects of Cardioversion in Chronic Atrial Fibrillation: Special Reference to Coronary Artery Disease

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Publisher
American Medical Association
Copyright
Copyright © 1972 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1972.00320030053005
Publisher site
See Article on Publisher Site

Abstract

Abstract The hemodynamic effects of conversion in chronic atrial fibrillation (AF) were studied in eight patients with coronary artery disease (CAD) (group 1) and five patients with AF of varied etiology (group 2). The resting stroke index (SI) in group 1 increased from 28.3 ml/sq m to 34.6 ml/sq m (P <.05) 30 minutes after conversion but the other parameters did not change. In patients who maintained normal sinus rhythm (NSR) three weeks following cardioversion the response to exercise was improved, with lower heart rate and higher cardiac index (CI), SI, and stroke work (SW). In relating filling pressures to SW, ventricular function was improved with NSR. Right atrial a waves returned simultaneously with NSR in 75% of patients whereas left atrial a waves appeared in 55%. Patients who failed to develop left atrial a waves immediately after cardioversion reverted to AF within three weeks. References 1. Lown B, Amarsingham R, Newman J: New method for terminating cardiac arrhythmias: Use of synchronized capacitor discharge. JAMA 182:548-555, 1962.Crossref 2. Hurst JW, Paulk EA Jr, Proctor HD, et al: Management of patients with atrial fibrillation. Amer J Med 37:728-741, 1964.Crossref 3. Killip T, Baer RA: Hemodynamic effects after reversion from atrial fibrillation to sinus rhythm by precordial shock. J Clin Invest 45:658-671, 1966.Crossref 4. Lown B: Electrical reversion of cardiac arrhythmias. Brit Heart J 29:469-488, 1967.Crossref 5. Mitchell JH, Gilmore JP, Sarnoff SJ: The transport function of the atrium: Factors influencing the relationship between mean left atrial pressure and left ventricular enddiastolic pressure. Amer J Cardiol 9:237-247, 1962.Crossref 6. Skinner N, Mitchell JH, Wallace AG, et al: Hemodynamic effects of altering the timing of atrial systole. Amer J Physiol 205:499-503, 1963. 7. Braunwald E: Symposium on cardiac arrhythmias: Introduction with comments on the hemodynamic significance of atrial systole. Amer J Med 37:665-669, 1964.Crossref 8. Mitchell JH, Gupta DN, Payne RM: Influence of atrial systole on effective ventricular stroke volume. Circ Res 17:11-18, 1965.Crossref 9. Samet P, Bernstein W, Levine S: Significance of atrial contribution to ventricular filling. Amer J Cardiol 15:195-202, 1965.Crossref 10. Ruskin J, Harley A, Rembert J, et al: Contribution of atrial systole to ventricular stroke volume in man. Circulation 38( (suppl 6) ):168, 1968.Crossref 11. Leinbach RC, Chamberlin DA, Kastor JA, et al: A comparison of the hemodynamic effects of ventricular and sequential AV pacing in patients with heart block. Amer Heart J 78:502-508, 1969.Crossref 12. Ruskin J, McHale PA, Harley A, et al: Pressure flow studies in man: Effect of atrial systole on left ventricular function. J Clin Invest 49:472-478, 1970.Crossref 13. Grettinger JS, Carleton RA, Muenster JJ: Circulatory consequences of changes in cardiac rhythm produced in patients by transthoracic direct current shock. J Clin Invest 43:2290-2302, 1964.Crossref 14. Duchelle RA: Indications for conversion of atrial fibrillation to normal sinus rhythm. Med Clin N Amer 50:117-125, 1966. 15. Morris JJ Jr, Entman M, North WC, et al: The changes in cardiac output with reversion of atrial fibrillation to sinus rhythm. Circulation 31:670-678, 1965.Crossref 16. Reale A: Acute effects of countershock conversion of atrial fibrillation upon right and left heart hemodynamics. Circulation 32:214-222, 1965.Crossref 17. Kahn DR, Kirsch MM, Ferguson PW, et al: Cardioversion after mitral valve operations. Circulation 35( (suppl 1) ):82-85, 1967.Crossref 18. Kaplan MA, Gray RE, Iseri LT: Metabolic and hemodynamic responses to exercise during atrial fibrillation and sinus rhythm. Amer J Cardiol 22:543-549, 1968.Crossref 19. Shapiro W, Kline G: Alterations in cardiac function immediately following electrical conversion of atrial fibrillation to normal sinus rhythm. Circulation 38:1074-1084, 1968.Crossref 20. Logan WF, Rollands WE, Howitt DJ, et al: Left atrial activity following cardioversion. Lancet 2:471-473, 1965.Crossref 21. Ikram H, Nixon PGF, Arcan T: Left atrial function after electrical conversions to sinus rhythm. Brit Heart J 30:80-83, 1968.Crossref 22. Oram S, Davies JPH, Weinbren I, et al: Conversion of atrial fibrillation to sinus rhythm by D.C. shock. Lancet 2:159-162, 1963.Crossref 23. Scott ME, Patterson GC: Cardiac output after direct current conversion of atrial fibrillation. Brit Heart J 31:87-90, 1969.Crossref 24. Ikram H, Nixon PGF, Arcan T: Direct current countershock for atrial fibrillation. Lancet 2:911, 1966.Crossref 25. Lindsay J: Pulmonary edema following cardioversion. Amer Heart J 74:434-435, 1967.Crossref 26. Halmos PB: Direct current conversion of atrial fibrillation. Brit Heart J 28:302-308, 1966.Crossref 27. Hall JI, Wood DR: Factors affecting cardioversion of atrial arrhythmias with special reference to quinidine. Brit Heart J 30:84-90, 1968.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1972

References