心房颤动复律后左房大小和左房功能的研究

目的 观察心房颤动转复前后左房大小、左房收缩功能的改变及两者的关系。方法 94例房颤患者中34例自发转复为窦律。60例被随机分为药物转复31例，直流电转复29例。所有患者房颤转复前后采用多谱勒超声心动图测定左房腔径、容量和A峰速度以评价左房大小和收缩功能。结果 转复后，左房腔径和容量均显著缩小（P＜0．01），A峰速度显著增快（P＜0．01），但电转复患者发生上述改变所需的时间相对较长。结论 房颤可使左房发生腔径扩大、收缩功能下降的改变。转复窦律后，上述改变可迅速逆转，但电转复因对心肌的损伤作用，而使上述逆转延迟发生。

Study of left atrial dimension and left atrial function after cardioversion for atrial fibrillation

Objective To observe the changes of left atrial dimension and f unction before and after cardioversion for atrial fibrillation (AF) and the rela tion between dimension and function.Methods Among 94 cases,34 ca ses who had spontaneous cardioversion converted to sinus rhythm,60 cases were ra ndomly grouped into 31 cases with drug cardioversion and 29 cases with direct-c urrent shock.Left atrial diameter,volume and A-wave velocity were measured to e valuate left atrial dimension and function using Dopplor echocardiogram in all c ases before and after cardioversion.Results After conversion,Lef t atrial diameter and volume decreased remarkably (P<0.01) and A- wave velocity increased remarkably (P< 0.01) which took comparati vely more time for patients converted with direct-current shock.Conclus ion Enlargement of left atrial and decrease of left atrial function occu r because of AF.These unfavourable changes are reversed rapidly after convertion to sinus rhythm in all patients but this reversion is delayed in patients conve rted with direct-current shock because direct-current shock can impair myocard ial tissues.