J Korean Soc Echocardiogr.  1994 Dec;2(2):179-186. 10.4250/jkse.1994.2.2.179.

Morphological Characteristics and Left Ventricular Function in Patients with Lone Atrial Fibrillation

• Chung IM
• Chung NS
• Choi DH
• Shim WH
• Cho SY
• Kim SS

• KMID: 2410446
• DOI: http://doi.org/10.4250/jkse.1994.2.2.179

Abstract

BACKGROUND
Lone atrial fibrillation(LAF) is defined by the presence of atrial fibrillation(AF) in the absence of any other clinical evidence to suggest a primary cardiac disease. In general, it has been accepted that LAF is a benign from of AF, but there is some evidence that LAF may induce atrial enlargement and left ventricular dysfunction. Atrial enlargement has also been reported to reduce the success rate of cardioversion to sinus rhythm, and in addition thrombus formation is more likely to occur in larger atria. Therefore this study was designed to detect any structural characteristics or functional abnormality in patients with LAF. METHOD: Twenty six patients with LAF(19 men and 7 women ; age 52±12 years) were studied by echocardiography and compared with 12 normal persons(2 men and 10 women ; age 47±7 years). Patients were divided into recurrent paroxysmal group(11 patients) and chronic group(15 patients) according to the character of LAF. Three orthogonal dimensions of both left atrium(LA) and right atrium(RA) were measured echocardiographically, and atrial volume was calculated. Peak early diastolic transmitral inflow velocity(E), peak velocity during atrial contraction(A), and deceleration time(DT) of E wave measured by Doppler echocardiography.
RESULTS
Cardiac abnormalities in patients include trivial mitral regurgitation(12 cases), trivial tricuspid regurgitation(8 cases), senile aortic valve sclerosis(7 cases), and mild senile calcification of mitral annulus(1 case) and papillary moscle(1 case). LA volume(65.1±32.8 vs 38.3±10.4cm2, p < 0.01), RA volume(65.6±23.0 vs 38.7± 10.3cm2, p < 0.01), and DT(216±32 vs 194±19msec, p < 0.05) were significantly increased in patients with LAF as compared with the cotrol group. RA volume(54.2±16.6 vs 38.7±10.3cm2, p < 0.05) and DT(231±23 vs 194±19msec) were significantly increased, and E/A(1.1±0.4 vs 1.4±0.3 p < 0.05) was signficantly decreased in the parxysmal group as compared with the control group. LA volume(78.4±33.9 vs 46.9±21.3cm2, p < 0.01) and RA volume(74.0±23.9 vs 54.2±16.6cm2, p < 0.05) were significantly increased and left ventricular ejection fraction(60±7 vs 68±6%, p < 0.01) tended to be decreased in the chronic group as compared with the paroxysmal group.
CONCLUSION
Atrial enlargement and left ventricular diastolic dysfunction were noted in patients with LAF. The degree of atrial enlargement in the chronic group was much more than that in the paroxysmal group. We conclude that LAF per se is associated with both atrial enlargement. Left ventricular diastolic dysfunction in these patients needs to be further investigated.

Keyword

Lone atrial fibillation; Atrial enlargement; Diastolic ventricular dysfunction

MeSH Terms

Aortic Valve
Atrial Fibrillation*
Deceleration
Echocardiography
Echocardiography, Doppler
Electric Countershock
Female
Heart Diseases
Humans
Male
Methods
Thrombosis
Ventricular Dysfunction, Left
Ventricular Function, Left*

Reference

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