Liakishev A A
Kardiologiia. 1977 Apr;17(4):77-82.
Echocardiography was employed in 39 patients with rheumatic mitral valve disease and atrial fibrillation prior to and following electric defibrillation. Patients under 60 years of age, mainly those subjected to a surgical correction of the disease, with a history of fibrillation under 3 years and without signs of thromboembolic complications in the past were selected for sinus rhythm restoration. The peculiarities of echocardiograms in different frequency of the ventricular rhythm are described. A correlation was found between the end diastolic and stroke volumes and the duration of the diastole in the preceeding cycle. The relationship of the ejection fraction and of the heart contractions rate was demonstrated: in sudden rhythm accelerations in 2 successive cycles the ejection fraction decreases in the 3rd cycle, and in sudden rhythm decelerations it increases. The echocardiographic manifestations of mechanically ineffective systoles are described. Sinus rhythm was restored by defibrillation in 80% of the cases. The haemodynamic parameters prior to and following the elimination of cardiac fibrillation are presented. It is concluded that an echocardiographic enlargement of the left atrium over 60 mm is an unfavourable prognostic sign for sinus rhythm restoration.
对39例风湿性二尖瓣疾病合并心房颤动的患者在电除颤前后进行了超声心动图检查。选择年龄在60岁以下、主要接受过疾病手术矫正、房颤病史在3年以内且既往无血栓栓塞并发症迹象的患者进行窦性心律恢复。描述了不同心室节律频率下超声心动图的特点。发现舒张末期容积和每搏量与前一心动周期的舒张期持续时间之间存在相关性。证实了射血分数与心率之间的关系：在连续两个心动周期中突然出现心律加速时，第三个心动周期的射血分数降低，而在突然出现心律减速时射血分数增加。描述了机械无效收缩期的超声心动图表现。80%的病例通过除颤恢复了窦性心律。给出了消除房颤前后的血流动力学参数。得出结论，左心房超声心动图增大超过60mm是窦性心律恢复的不良预后指标。
