Falcone R A, Morady F, Armstrong W F
University of Michigan Hospital, Ann Arbor, USA.
Am J Cardiol. 1996 Aug 15;78(4):435-9. doi: 10.1016/s0002-9149(96)00333-5.
Changes in left atrial (LA) appendage pulsed-wave Doppler velocities and changes in grades of spontaneous contrast occur immediately after electrical cardioversion of atrial fibrillation (AF) using transesophageal echocardiography (TEE). The effect of sequential ineffective electrical cardioversion attempts or chemical cardioversion on these parameters is unknown. TEE was performed in 23 patients with chronic AF. Doppler velocities and grades of spontaneous contrast were assessed before and after each cardioversion attempt until sinus rhythm was achieved. Doppler emptying and filling velocities were significantly decreased after electrical (0.39 +/- 0.14 vs 0.27 +/- 0.16 [p = 0.01] and 0.43 +/- 0. 18 vs 0.30 +/- 0.14 m/s [p = 0.01]) or chemical cardioversion to sinus rhythm (0.65 +/- 0.18 vs 0.31 +/- 0.06 [p = 0.03] and 0.64 +/- 0.22 vs 0.44 +/- 0.17 m/s [p = 0.04]). Spontaneous contrast developed in 1 of 3 patients after chemical conversion to sinus rhythm and was present in 11 of 20 patients before electrical cardioversion, developing in 4 patients and intensifying in 2 patients immediately after successful cardioversion. These phenomena were not seen after ineffective electrical or chemical cardioversion attempts. This suggests that restoration of sinus rhythm is in itself responsible for these phenomena, not the method by which sinus rhythm is achieved.
采用经食管超声心动图（TEE）观察心房颤动（AF）患者电复律后即刻左心房（LA）附件脉冲波多普勒速度的变化以及自发显影等级的变化。连续无效电复律尝试或药物复律对这些参数的影响尚不清楚。对23例慢性AF患者进行了TEE检查。在每次复律尝试前后评估多普勒速度和自发显影等级，直至恢复窦性心律。电复律（0.39±0.14 vs 0.27±0.16 [p = 0.01]以及0.43±0.18 vs 0.30±0.14 m/s [p = 0.01]）或药物复律至窦性心律（0.65±0.18 vs 0.31±0.06 [p = 0.03]以及0.64±0.22 vs 0.44±0.17 m/s [p = 0.04]）后，多普勒排空和充盈速度显著降低。药物复律至窦性心律后，3例患者中有1例出现自发显影，电复律前20例患者中有11例存在自发显影，成功复律后4例患者出现自发显影，2例患者自发显影增强。无效电复律或药物复律尝试后未观察到这些现象。这表明窦性心律的恢复本身是这些现象的原因，而非实现窦性心律的方法。
