Hemodynamic Effects of Cardioversion in Chronic Atrial Fibrillation

The hemodynamic effects of conversion in chronic atrial fibrillation (AF) were studied in eight patients with coronary artery disease (CAD) (group 1) and five patients with AF of varied etiology (group 2). The resting stroke index (SI) in group 1 increased from 28.3 ml/sq m to 34.6 ml/sq m (P <.05) 30 minutes after conversion but the other parameters did not change. In patients who maintained normal sinus rhythm (NSR) three weeks following cardioversion the response to exercise was improved, with lower heart rate and higher cardiac index (CI), SI, and stroke work (SW). In relating filling pressures to SW, ventricular function was improved with NSR. Right atrial a waves returned simultaneously with NSR in 75% of patients whereas left atrial a waves appeared in 55%. Patients who failed to develop left atrial a waves immediately after cardioversion reverted to AF within three weeks.