ECHOCARDIOGRAPHIC FACTORS PREDICTING THE MAINTENANCE OF SINUS RHYTHM ONE-YEAR AFTER CARDIOVERSION FOR NONVALVULAR ATRIAL ARRHYTHMIAS

Echocardiographic factors predictive of the maintenance of sinus rhyth m after successful cardioversion were investigated in 94 patients with non-valvular atrial arrhythmias of recent onset. Seventy-five patient s with atrial fibrillation and 19 with atrial flutter admitted for red uction of their arrhythmias underwent transthoracic and transoesophage al echocardiography. After excluding a thrombus in the left atrial app endage or checking that it had disappeared (5 patients), and electrica l (n = 74) or pharmacological (n = 20) cardioversion was successfully per formed. The maintenance of sinus rhythm (n = 44) or recurrence of arrhythmia (n = 50) were controlled every 3 months for one year. The m ean value of the peak positive blood flow in the left atrial appendage was 38 +/- 20 cm/s for the whole group. It was not possible to identi fy an echocardiographic parameter predictive of maintenance of sinus r hythm at one year either in the whole group or in the subgroups with a trial flutter or atrial fibrillation. In the group in atrial flutter, the mean value of the peak positive blood flow in the left atrial appe ndage was significantly greater than in the group with atrial fibrilla tion: 49 +/- 22 cm/s vs 35 +/- 18 cm/s, respectively; p < 0.05. The pe ak of positive flow in the left atrial appendage was statistically rel ated to indirect parameters of left atrial function and of left ventri cular function in the group with atrial fibrillation but only with par ameters of left ventricular function in the smaller group with atrial flutter.