N.P. Levchuk, О.J. Zharinov, М.R. Ikorkin, О.S. Sychov. Changes of the myocardial structure and function in patients with persistent atrial fibrillation after cardioversion at long-term follow-up.

The aim – to compare dynamics of the myocardial structure and function parameters in patients with persistent non-valvular atrial fibrillation (AF) during 18 months after cardioversion depending on sinus rhythm maintenance.

Material and methods. The prospective follow-up included 225 consecutive patients selected for planned cardioversion. Apart from general clinical data, the protocol included transtorathic and transesophageal echocardiography for detailed evaluation of structure and function of atrial and ventricles.

Results. Sinus rhythm was maintained in 125 (55.6 %) patients at 18-months follow-up. Persistent or permanent AF was registered in 100 patients (44.4 %), including 47 – after 6 months, in 23 – after 12, in 30 – after 18 months follow-up. Maintenance of sinus rhythm at 18-months follow-up was associated with transition of the majority patients to better functional class NYHA, significant improvement of the myocardial structure and function parameters, decrease of mitral and tricuspidal regurgitation. AF recurrence was associated with decrease of the left atrial appendage function.

Conclusions. These data show that strategy of cardioversion and rhythm maintenance is an effective way to prevent «tachycardiomyopathy» in patients with symptomatic persistent AF.

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