title: Impaired left atrial mechanical function after cardioversion: relation to the duration of atrial fibrillation.
abstract: OBJECTIVE
  We hypothesized that the time course of the recovery of atrial systolic function may be related to the duration of atrial fibrillation before cardioversion and sought to study noninvasively the recovery of left atrial mechanical function utilizing serial transthoracic Doppler studies.
  
  
  BACKGROUND
  Recovery of atrial mechanical function may be delayed for several weeks after successful cardioversion of atrial fibrillation to sinus rhythm.
  
  
  METHODS
  After successful cardioversion, 60 patients with atrial fibrillation of brief (< or = 2 weeks, 17 patients), moderate (> 2 to 6 weeks, 22 patients) or prolonged (> 6 weeks, 21 patients) duration were followed up with serial transmitral pulsed Doppler echocardiography immediately (60 patients) and at 24 h (45 patients), 1 week (41 patients), 1 month (31 patients) and > 3 months (30 patients) after cardioversion.
  
  
  RESULTS
  Atrial mechanical function is greater immediately and at 24 h and 1 week after cardioversion in patients with "brief" compared with "prolonged" atrial fibrillation. In all groups, atrial mechanical function increases over time, ultimately achieving similar levels. Full recovery of atrial mechanical function, however, is achieved within 24 h in patients with brief atrial fibrillation, within 1 week in patients with moderate-duration atrial fibrillation and within 1 month in patients with prolonged atrial fibrillation.
  
  
  CONCLUSIONS
  Recovery of left atrial mechanical function is related to the duration of atrial fibrillation before cardioversion. These findings have important implications for assessing the early hemodynamic benefit of successful cardioversion.
authors.affiliation: Charles A. Dana Research Institute, Boston, Massachusetts.
authors.forename: W J
authors.initials: WJ
authors.lastname: Manning
authors.forename: D I
authors.initials: DI
authors.lastname: Silverman
authors.forename: S E
authors.initials: SE
authors.lastname: Katz
authors.forename: M F
authors.initials: MF
authors.lastname: Riley
authors.forename: P C
authors.initials: PC
authors.lastname: Come
authors.forename: R M
authors.initials: RM
authors.lastname: Doherty
authors.forename: J T
authors.initials: JT
authors.lastname: Munson
authors.forename: P S
authors.initials: PS
authors.lastname: Douglas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000628:therapy*; D015150:Echocardiography, Doppler; D004554:Electric Countershock; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors