Echographic Assessment of Atrial Transport, Mitral Movement, and Ventricular Performance Following Electroversion of Supraventricular Arrhythmias

Echographic Assessment of Atrial Transport, Mitral Movement, and Ventricular Performance Following Electroversion of Supraventricular Arrhythmias
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室上性心律失常电复律后心房运输、二尖瓣运动和心室性能的超声心动图评估

DOI:
10.1161/01.cir.51.2.273
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发表时间:
1975
期刊:
影响因子:
37.8
通讯作者:
D. Mason
D. Mason
中科院分区:
医学1区
文献类型:
--
作者:
A. DeMaria;J. E. Lies;J. King;Richard R. Miller;E. Amsterdam;D. Mason

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Controversy attends the extent and temporal sequence of improvements in hemodynamic function resulting from the return of atrial contraction following cardioversion of supraventricular arrhythmias. Thus, mitral, left atrial (LA) and left ventricular (LV) echograms were obtained before and one hour after conversion of supraventricular arrhythmias to normal sinus rhythm by direct current countershock in patients with chronic coronary disease or cardiomyopathies without valvular dysfunction. The duration of the rhythm disturbance varied from one day to five years in 22 patients and was indeterminate in 13. Atrial systole immediately produced prominent mitral "A" waves with anterior valve excursion of 7.5 mm (range 3 to 12) in 33 of the 35 patients (94%). The two patients with atrial electromechanical dissociation reverted to atrial fibrillation within one week. Cardioversion caused a decline in LA diameter (3.5 to 3.2 cm, P < .001) and a rise in LV end-diastolic dimension (5.2 to 5.5 cm, P < .001) while LV end-systolic dimension was unchanged (4.2 cm). Thereby stroke volume rose. Heart rate fell an average of 16 beats/min. Depressed cardiac output was improved + 0.84 L/min/m2. Thus, in the majority of patients with acute or chronic supraventricular arrhythmias without mitral valve disease, cardioversion promptly restores effective atrial contraction, decreases LA size, and results in substantial hemodynamic benefit.