HEMODYNAMICS AND ECHOCARDIOGRAMS BEFORE AND AFTER CARDIOVERSION OF ATRIAL-FIBRILLATION TO NORMAL SINUS RHYTHM

Hemodynamic and echocardiographic measurements were obtained in 15 patients prior to cardioversion and immediately, one, three, and five hours after cardioversion of atrial fibrillation to normal sinus rhythm. At five hours after cardioversion, there was improvement in cardiac index (P < 0.005), in stroke index (P < 0.005), and in stroke work index (P < 0.025), but no significant change in heart rate, mean pulmonary capillary wedge pressure, left atrial dimensions (LAD), left ventricular end-diastolic dimensions (LVEDD), or left ventricular end-systolic dimension (LVESD). At follow-up one week to nine months after cardioversion, 10 of the 15 patients (67 percent) remained in normal sinus rhythm. Neither the size of the left atrium, changes in hemodynamics, LAD, LVEDD, or LVESD, nor the presence or amplitude of the A-wave on the mitral valve echogram correlated with the persistence of normal sinus rhythm.