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Abstract
Atrial fibrillation (AF) and congestive heart failure (CHF) are recognized as 2 major epidemics of cardiovascular disease.
CHF is the strongest risk factor for development of AF. However,
several studies during a 50-year period have provided evidence that AF
may precipitate or exacerbate LV dysfunction, giving rise to AF- induced
cardiomyopathy, these studies suggested that chronic, uncontrolled
tachycardia may result in sever global LV dysfunction that may resolve
completely over a period of several months with rate control. In some
patients permanent damage could occur.
Our study aimed at identifying the effect of Atrial fibrillation on the
left ventricular function in patients with dilated cardiomyopathy and
prognostic significance of it’s control.
In this study 75 patients (50 AF patients – 25 SR patients) of dilated
cardiomyopathy complaining of symptoms of congestive heart failure
were analyzed to evaluate the left ventricular function both clinically and
Echo-cardiographically before and after treatment.
50 patients ( 66.67%) had either transient (15 patients) or persistent (
35 patients) Atrial fibrillation. Compared with DCM patients with sinus
rhythm (SR), the AF patients did not in age, left ventricular dimension,
ejection fraction, but the AF patients had slightly larger left atria. After a
follow- up of six months, the NYHA functional classification in the AF
patients improved in 25 of the 50 (50%) (p=0.001), whereas those of the
SR patients improved only in 5 of the 23 patients.
LV function remained unchanged in SR patients but improved
significantly in AF patients, particularly in patients with transient AF and
with ’’rate-controlled’’ AF ( those with a mean heart rate of less than 90
beats/min)