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Europace 2003 5(1):17-23; doi:10.1053/eupc.2002.0285
© 2003 by European Society of Cardiology
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Relationship between the frequency of paroxysmal episodes of atrial fibrillation and pulmonary venous flow pattern

K. S. Lindgren1, M. J. Pekka Raatikainen1, K. E. Juhani Airaksinen2 and H. V. Huikuri1

1University of Oulu, Department of Internal Medicine, Division of Cardiology, Oulu University Hospital Oulu, Finland; 2University of Turku, Cardiology Unit, Department of Internal Medicine Turku, Finland

AIMS: Chronic atrial fibrillation causes mechanical remodelling of the atria, but it is uncertain whether self-terminating episodes of paroxysmal atrial fibrillation (PAF) alter atrial mechanical function during normal sinus rhythm. This study was designed to assess the relationship between the frequency of symptomatic arrhythmic episodes and pulmonary venous flow (PVF) pattern among patients with PAF.

METHODS AND RESULTS: The effect of symptomatic arrhythmic episodes on PVF was studied in 85 patients with lone PAF (age 48±8 years, 66 men). PVF was measured with transthoracic echocardiography during sinus rhythm. Adequate recordings of PVF were achieved in 81 (95%) patients. Peak systolic PVF had an inverse correlation (r=–0·35, P=0·002) with the frequency of PAF episodes. The peak systolic PVF was 76±14 cm/s vs 62±12 cm/s (P=0·008) among the quartiles with the most and the least frequent episodes of PAF, respectively. There were no significant differences in the other echocardiographic measurements or demographic variables.

CONCLUSIONS: Frequent arrhythmic episodes significantly diminished systolic PVF among patients with PAF, suggesting that PAF results in gradual mechanical remodelling of the atrium, which may favour recurrence and perpetuation of AF and/or formation of atrial thrombus.

Key Words: Pulmonary venous flow, paroxysmal atrial fibrillation

Correspondence: Prof. Heikki V. Huikuri, MD, University of Oulu, Department of Internal Medicine, Division of Cardiology, P.O. Box 5000, FIN-90014 University of Oulu, Finland. Tel.: +358-8-315 4108; Fax: +358-8-315 5599; E-mail: heikki.huikuri{at}oulu.fi


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