CORRECTION OF STRUCTURAL-CHANGES OF THE L EFT-HEART IN PATIENTS WITH EFFECTIVE PREVENTIVE TREATMENT OF RECURRENT ATTACKS OF PAROXYSMAL ATRIAL-FIBRILLATION

Patients (n=149) with hypertension and/or ischemic heart disease and f requent attacks of atrial fibrillation were studied by echocardiograph y. Increases of left atrial volume index and left ventricular hypertro phy were registered in 91,3 and 49,7% of cases, respectively. Moderate increase of left ventricular wall thickness and cavity enlargement we re also found. Maintenance of sinus rhythm for 12 months by individual ly selected antiarrhythmic drugs (allapinin, ethacizine, propafenone, amiodarone) led to modest reduction of hypertrophy and of left heart d ilatation. These processes were accelerated and augmented when slow re lease nifedipine, verapamil or enalapril were used in combination with antiarrhythmic therapy. As structural-geometric derangements of the l eft heart are potent risk factors of atrial fibrillation their modific ation possibly facilitates prevention of attacks and precludds transit ion from paroxysmal to chronic atrial fibrillation.