The association of chronic atrial fibrillation with right atrial dilatation and left ventricular dysfunction in the elderly.
BACKGROUND
Left atrial dilatation is often considered as one of the important causes for atrial fibrillation. In this study we sought to examine the relationship between right atrial dilatation and left ventricular function in patients with atrial fibrillation, and the association with the documented duration of the dysrrhythmia.


METHODS
56 consecutive patients with atrial fibrillation were investigated by means of clinical history, electrocardiography and echocardiography.


RESULTS
Right atrial dilatation was found in 34, left atrial dilatation in 36 and bi-atrial dilatation in 31 patients. Patients with a dilated right atrium had a larger left atrium, lower left ventricular shortening fraction, and higher transmitral flow velocity than those with a normal right atrium. A history of atrial fibrillation of over 6 months was associated with enlarged atria, reduced left ventricular shortening fraction and increased transmitral flow compared to that of 3 months or less. Functional mitral and tricuspid regurgitation were only found in patients whose atrial fibrillation was over 6 months in duration.


CONCLUSIONS
Dilatation of both right and left atria is common in chronic atrial fibrillation, and is associated with impaired left ventricular function. A longer duration of atrial fibrillation predisposes to atrial dilatation, left ventricular dysfunction, and functional atrio-ventricular regurgitation. These findings suggest that atrial fibrillation may have a significant contribution to morphological and functional cardiac changes, and raise the possibilities that early cardioversion or adequate rate control might prevent these changes and may improve prognosis in the elderly.
Cardiology, Central Middlesex Hospital, London, UK. hanbinxiao@hotmail.com
Han B
HB
Xiao
Syed A H
SA
Rizvi
Daniel
D
McCrea
Brian
B
Kaufman
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation; D004108:Dilatation, Pathologic; D018619:Echocardiography, Doppler, Pulsed; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D018487:Ventricular Dysfunction, Left