Circulation, Vol 82, 792-797, Copyright © 1990 by American Heart Association
AJ Sanfilippo, VM Abascal, M Sheehan, LB Oertel, P Harrigan, RA Hughes and AE Weyman
To test the hypothesis that atrial enlargement can develop as a consequence
of atrial fibrillation, left and right atrial dimensions were measured
echocardiographically at two different time points in patients with atrial
fibrillation. Patients were selected who initially had normal atrial sizes
and who had no evidence of significant structural or functional cardiac
abnormalities other than atrial fibrillation either by history or
two-dimensional and Doppler echocardiography. Fifteen patients were studied
(12 men and three women; mean age, 67.3 years). Average time between
studies was 20.6 months. Three orthogonal left atrial dimensions and two
right atrial dimensions were measured, and all were found to increase
significantly between studies. Also, highly significant increases in
calculated left atrial volume (from 45.2 to 64.1 cm3, p less than 0.001)
and right atrial volume (from 49.2 to 66.2 cm3, p less than 0.001) were
observed. The relative extents of left and right atrial volume increase did
not differ, and left ventricular size did not change significantly between
studies. These results indicate that atrial enlargement can occur as a
consequence of atrial fibrillation. The maintenance of sinus rhythm,
therefore, may prevent atrial enlargement and its adverse clinical effects.
ARTICLES
Atrial enlargement as a consequence of atrial fibrillation. A prospective echocardiographic study
Cardiac Unit, Massachusetts General Hospital, Harvard Medical School, Boston.
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