title: Atrial mechanical performance after internal and external cardioversion of atrial fibrillation: an echocardiographic study.
abstract: OBJECTIVE
  To compare the time course of resumption of mechanical performance of the left and right atrium after the novel method of internal low-energy cardioversion (CV) and conventional external CV of atrial fibrillation (AF).
  
  
  BACKGROUND
  Right atrial performance has been shown to normalize before the left atrium after external CV. However, no data on atrial function after internal CV are available.
  
  
  METHODS
  Sixty-three patients with chronic AF were randomized to participate in either external or internal CV.
  
  
  METHODS
  Echocardiographic examinations were carried out before as well as immediately after CV (day 0), and at days 1, 7, and 28 thereafter for the determination of cardiac dimensions, volumes, and transvalvular flow patterns.
  
  
  RESULTS
  After randomized internal CV or external CV, stable sinus rhythm was restored in 59 patients. Irrespective of the mode of CV, the right atrium resumed its mechanical function immediately after CV, whereas the left atrium was stunned beyond day 7. The mode of CV, internal or external, had no influence on the recovery of atrial mechanical function.
  
  
  CONCLUSIONS
  The right atrium resumes its normal function immediately after internal as well as external CV, whereas left atrium function is delayed. In contrast to the assumption that low-energy internal CV would impact less on atrial mechanical recovery, the type of method of CV used has no effect on such recovery.
authors.affiliation: Deutsches Herzzentrum, Klinikum an der Technischen Universität München, Germany.
authors.forename: Günter
authors.initials: G
authors.lastname: Lehmann
authors.forename: Jörg
authors.initials: J
authors.lastname: Horcher
authors.forename: Karl
authors.initials: K
authors.lastname: Dennig
authors.forename: Andreas
authors.initials: A
authors.lastname: Plewan
authors.forename: Kurt
authors.initials: K
authors.lastname: Ulm
authors.forename: Eckhard
authors.initials: E
authors.lastname: Alt
mesh_terms: D000368:Aged; D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000503:physiopathology; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D016279:Atrial Function, Left / Q000502:physiology*; D016280:Atrial Function, Right / Q000502:physiology; D002908:Chronic Disease; D017147:Defibrillators, Implantable; D017548:Echocardiography, Transesophageal; D004554:Electric Countershock; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged