Study objectives: To investigate the effect of atrial
fibrillation (AF) on pulmonary venous flow (PVF) patterns in a cohort
with nonrheumatic AF.
Design and settings: A
prospective and controlled study undertaken at a tertiary referral
Patients and measurements: The
echocardiographic parameters of left superior PVF as assessed by
Doppler transesophageal echocardiography in 40 patients with chronic AF
(group 1) were compared to those of 33 volunteers with sinus rhythm
(group 2) and well-matched baseline characteristics.
Results: All group 1 patients presented with single
systolic forward flow (SFF) patterns. In contrast, single and double
SFF patterns were found equally in group 2. With regard to reverse flow
(RF), most group 1 patients (33 of 40) had an early systolic RF and
none had atrial RF; however, most group 2 subjects (29 of 33) had an
atrial RF. Some of the group 1 patients (17%) had a late systolic RF
in the absence of significant mitral regurgitation. In group 1, the SFF
appeared later and disappeared earlier than in group 2. The mean
systolic peak velocity and time-velocity integral (TVI) of the SFF were
significantly lower in group 1 compared to group 2. The diastolic peak
velocity and TVI were not significantly different between groups.
Conclusions: Our data indicate that AF independently and
significantly affects the PVF and leads to characteristic flow patterns
different from sinus rhythm. The presence of AF reduces SFF in addition
to the absence of atrial RF. These changes in the flow patterns should
be taken into account while interpreting the implications of PVF in the
presence of AF.