Pérez Y, Duval A M, Carville C, Wéber H, Cachin J C, Castaigne A, Guéret P
Fédération de cardiologie, hôpital Henri-Mondor, Créteil.
Arch Mal Coeur Vaiss. 1997 Jul;90(7):911-8.
Echocardiographic factors predictive of the maintenance of sinus rhythm after successful cardioversion were investigated in 94 patients with non-valvular atrial arrhythmias of recent onset. Seventy-five patients with atrial fibrillation and 19 with atrial flutter admitted for reduction of their arrhythmias underwent transthoracic and transoesophageal echocardiography. After excluding a thrombus in the left atrial appendage or checking that it had disappeared (5 patients), and electrical (n = 74) or pharmacological (n = 20) cardioversion was successfully performed. The maintenance of sinus rhythm (n = 44) or recurrence of arrhythmia (n = 50) were controlled every 3 months for one year. The mean 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 identify an echocardiographic parameter predictive of maintenance of sinus rhythm at one year either in the whole group or in the subgroups with atrial flutter or atrial fibrillation. In the group in atrial flutter, the mean value of the peak positive blood flow in the left atrial appendage was significantly greater than in the group with atrial fibrillation: 49 +/- 22 cm/s vs 35 +/- 18 cm/s, respectively; p < 0.05. The peak of positive flow in the left atrial appendage was statistically related to indirect parameters of left atrial function and of left ventricular function in the group with atrial fibrillation but only with parameters of left ventricular function in the smaller group with atrial flutter.
在94例近期发病的非瓣膜性房性心律失常患者中,研究了与成功复律后窦性心律维持相关的超声心动图因素。75例房颤患者和19例房扑患者因心律失常减轻入院,接受了经胸和经食管超声心动图检查。在排除左心耳血栓或确认血栓已消失(5例患者)后,成功进行了电复律(n = 74)或药物复律(n = 20)。对窦性心律维持情况(n = 44)或心律失常复发情况(n = 50)每3个月进行一次为期一年的监测。整个组左心耳正向血流峰值的平均值为38±20 cm/s。无论是在整个组还是在房扑或房颤亚组中,均无法确定一个预测一年窦性心律维持的超声心动图参数。在房扑组中,左心耳正向血流峰值的平均值显著高于房颤组:分别为49±22 cm/s和35±18 cm/s;p<0.05。在房颤组中,左心耳正向血流峰值与左心房功能和左心室功能的间接参数有统计学关联,但在较小的房扑组中仅与左心室功能参数有关。