TY - JOUR
T1 - Clinical significance of fibrillatory wave amplitude
T2 - A clue to left atrial appendage function in nonrheumatic atrial fibrillation
AU - Li, Y. H.
AU - Hwang, J. J.
AU - Tseng, Y. Z.
AU - Kuan, P.
AU - Lien, W. P.
N1 - Funding Information:
This study was supported by grant NSC 83-0412-B-002-157 from the National Science Council, Executive Yuan, Republic of China.
PY - 1995
Y1 - 1995
N2 - Seventy-eight patients with chronic nonrheumatic atrial fibrillation were studied by transesophageal echocardiography with regard to the left atrial appendage function and its relation to the coarseness of atrial fibrillation on electrocardiogram. These 78 patients (52 men and 26 women; mean age, 66±10 years; range, 40 to 94 years) were classified into two groups according to the presence of coarse (group 1, n=46; those with the greatest amplitude of fibrillatory wave in lead V1≥1 mm) or fine (group 2, n=32; those without the coarse fibrillatory wave in lead V1) atrial fibrillation on a standard 12-lead electrocardiogram within 1 month of echocardiographic studies. There were no significant differences in age, sex, mean duration of atrial fibrillation, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, left ventricular ejection fraction, and left atrial dimension between the two groups. In group 1, however, the left atrial appendage ejection fraction (24.4±14.2% vs 32.6±14.8%; p<0.05) and the peak emptying velocity (21.7±12.6 cm/s vs 30.4±14.3 cm/s; p<0.01) were lower than those in group 2. There were higher incidences of left atrial appendage spontaneous echo contrast (26/46 vs 7/32; p<0.005) and thrombus (8/46 vs 0/32; p<0.05) in group 1 patients. The coarse atrial fibrillation revealed a sensitivity of 80.0%, a specificity of 58.1%, a positive predictive value of 60.9%, and a negative predictive value of 78.1% for the presence of left atrial appendage spontaneous echo contrast and/or thrombus formation. In conclusion, in patients with coarse nonrheumatic atrial fibrillation, the left atrial appendage function is usually poor and the incidence of spontaneous echo contrast and thrombus formation appears to be higher in these patients.
AB - Seventy-eight patients with chronic nonrheumatic atrial fibrillation were studied by transesophageal echocardiography with regard to the left atrial appendage function and its relation to the coarseness of atrial fibrillation on electrocardiogram. These 78 patients (52 men and 26 women; mean age, 66±10 years; range, 40 to 94 years) were classified into two groups according to the presence of coarse (group 1, n=46; those with the greatest amplitude of fibrillatory wave in lead V1≥1 mm) or fine (group 2, n=32; those without the coarse fibrillatory wave in lead V1) atrial fibrillation on a standard 12-lead electrocardiogram within 1 month of echocardiographic studies. There were no significant differences in age, sex, mean duration of atrial fibrillation, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, left ventricular ejection fraction, and left atrial dimension between the two groups. In group 1, however, the left atrial appendage ejection fraction (24.4±14.2% vs 32.6±14.8%; p<0.05) and the peak emptying velocity (21.7±12.6 cm/s vs 30.4±14.3 cm/s; p<0.01) were lower than those in group 2. There were higher incidences of left atrial appendage spontaneous echo contrast (26/46 vs 7/32; p<0.005) and thrombus (8/46 vs 0/32; p<0.05) in group 1 patients. The coarse atrial fibrillation revealed a sensitivity of 80.0%, a specificity of 58.1%, a positive predictive value of 60.9%, and a negative predictive value of 78.1% for the presence of left atrial appendage spontaneous echo contrast and/or thrombus formation. In conclusion, in patients with coarse nonrheumatic atrial fibrillation, the left atrial appendage function is usually poor and the incidence of spontaneous echo contrast and thrombus formation appears to be higher in these patients.
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U2 - 10.1378/chest.108.2.359
DO - 10.1378/chest.108.2.359
M3 - Article
C2 - 7634867
AN - SCOPUS:0029081040
SN - 0012-3692
VL - 108
SP - 359
EP - 363
JO - Chest
JF - Chest
IS - 2
ER -