Left atrial remodelling after short duration atrial fibrillation in hypertrophic hearts

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia found in hypertensive patients. AF causes atrial dilation, and progressive left atrial (LA) enlargement occurs once AF becomes chronic. In the Framingham heart study, LA enlargement was associated both with the duration of elevated blood pressure and with the level of systolic pressure.1 The mechanism by which hypertension leads to LA enlargement seems to be related to haemodynamic changes. The LA size is closely related to diastolic filling pressure. We investigated 80 consecutive hypertensive patients with moderate left ventricular (LV) hypertrophy presenting with short duration AF (group A). The control population included 80 patients with lone AF and without cardiac hypertrophy (group B). The protocol was approved by the ethical committee and all patients signed an informed consent form. Patients underwent external DC shock. Cardiac evaluation included a complete echocardiogram. The following parameters were measured and compared. LA diameters were measured during systole along the parasternal long and short axis views. LA volumes were determined at mitral valve opening (maximal volume), at onset of atrial systole (p wave of ECG, P volume), and at mitral valve closure (minimal volume). LA volumes were measured from the apical four chamber and two chamber views …