A Clinical Appraisal of Atrial Transport Function

Heart

“…In an other investigation, selective angiocardiograms with left ventricular opacifi cation in a large number of patients having a variety of cardiac arrhythmias, resulting either in the absence of atrial systole or in an abnormal temporal re lationship between atrial and ventricular contractions, revealed no evidence of mitral regurgitation (156). From this observation it appears that a prop erly timed atrial contraction is not always essential for effective closure of the mitral valve in man, a view consistent with data obtained in experimental animals utilizing indicator dilution techniques (155).…”

“…The data concerning the possible role of atrial contraction in the closure of the atrioventricular valves have been reviewed by Burchell (155). In an other investigation, selective angiocardiograms with left ventricular opacifi cation in a large number of patients having a variety of cardiac arrhythmias, resulting either in the absence of atrial systole or in an abnormal temporal re lationship between atrial and ventricular contractions, revealed no evidence of mitral regurgitation (156).…”

Long-term results of DC reversion of atrial fibrillation.

“…Whatever the haemodynamic advantages of co-ordinate and appropriately-phased atrial contraction (Braunwald, 1964;Burchell, 1964), restoration of sinus rhythm seems therapeutically justifiable only when it is likely to persist for a worth-while period; otherwise any such advantages will be ephemeral and the risk of embolism is unlikely to be favourably influenced. We, therefore, attempted to clarify the position by follow-up of patients treated over two years ago in order to determine the rates of persistence of normal rhythm at one or two years after reversion in different aetiological groups.…”

Hemodynamic effects after conversion of arrhythmias

“…Although there are many sources of error in the quantitation of mitral insufficiency by indicator dilution curves, evaluation by this method suggests that conversion of atrial fibrillation to sinus rhythm decreases the degree of mitral insufficiency in some but not all patients (Fig. 3) (43,47,48).…”