Left Atrium Before And After Electrical Cardioversion Of Atrial Fibrillation Patients. Transesophageal Echocardiography Evaluation Function

Aim: To evaluate the left atrial function of the patients of atrial fibrilltion under transesophageal echocardiographic guidance before and after electrical cardioversion. Methods: 18 nonvalvular patients with atrial fibrillation were included in this study.Hypertension(6), dilated cardiomyopathy(6),cerebrovascularaccident(4) and ischemic heart disease(2) were associated. Atrial fibrillation lasted at least for 2 weeks.precardioversion transesophageal echocardiographic parameters were measured after exclusion of thrombi in the left atrium. Immediately after sinus conversion, echocardiographic parameters were measured again,left atrial appendage flow velocity and -3- time-velocity-integral(T VI), deceleration time (DT) were measured. Results:The left atri al appendage emptying velocity decreased while the emptying index increased significantly after sinus conversion. The highest systolic and diastolic velocity of pulmonic vein and TVI increased markedly after sinus after sinus conversion.The highest velOocity of thrombi in the left atrium. Immediately after sinus conversion, echocardiographic parameters were measured again, Left atrial appendage flow velocity and time-velocity-integral (TVJ),deceleration time(DT) were measured. Results: The left atri al appendage emptying velocity decreased while the emptying index increased singnificantly after sinus conversion. The highest systolic and diastolic velocity of pulmonic vein and TVJ increased markedly after sinus conversion. The highest velocity of transmitral E and E/A ratio were increased too.Conclusion: After appropriate anticoagulation theraphy and exclusuion of left atrium and left atrial appendage thrombi with TEE we .4.. could perform electrical c~rdioversion safely without complications.TEE could evaluate the left atrial function of the patients of atrial fibrillation before and after electrical cardioversion.Electrjcal cardioversion decreeased electrical and mechanical activity of atrium and it can also cause left atrial disfunction and thrombi, These findings necessitates extended anticoagulation theraphy untill the full recovery of atrial mechanical tunction.