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Does atrial fibrillation induce atrial myopathy?
Rakovec, Peter ; Ružič-Medvešček, Nadja
Clinical experience has shown that pharmacologic or electric reversion of atrial fibrillation is less likely if this arrhythmia is of longes been shown as well that the patients with atrial ...fibrillation of shorter duration have agreater chance of maintaining sinus rhythm after cardioversion. Animal experiments demonstrated that atrial fibrillation begets atrial fibrillation; repeatedly induced atrial fibrillation eventually resulted in chronic fibrillation. On the other hand, there is a lot of evidenc e that, after cardioversion, a longer period of time is needed for atrial contractions to become efficient. In our laboratory we have observed left atrial dilation i npatients with hypertensive heart disease, early onset of atrial fibrillation and as its consequence huge biatrial dilatation without any other cause for right atrial myopathy. Our experience also demonstrates gradual impovement of atrial function after restoration of sinus rhythm. Several studies on left ventricular function after prolonged episodes of tachycardia have shown impairment of ejection fraction; the degree of this impairment depends upon the rate and duration of tachycardia. It is very likely, therefore, that atrial tachyarrhythmia causes a similar dysfunction of the atrial muscle as the ventricular tachycardia does on ventricular level. Prompt pharmacologic orelectric reversion seems therefore to be of utmost importance for maintenance of sinus rhythm. Thus the introduction of atrial defibrillator into clinical practice represents a promising therapeutic modality.
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