Abstract:
:Forty patients with atrial fibrillation and 20 patients with congestive heart failure and sinus rhythm were studied. Patients were divided into two groups. Group A consisted of 20 patients with atrial fibrillation in whom systolic time intervals were measured. Twenty to 50 beats were analyzed. Five of the patients had high-fidelity measurements of left ventricular pressure simultaneous with determination of systolic time intervals. Analysis of the systolic time intervals for the entire group showed that the preejection period lengthened at faster heart rates and that the left ventricular ejection time was relatively constant at slower heart rates. This resulted in a progressive increase in the ratio of preejection period over left ventricular ejection time (PEP/LVET) as the heart rate increased. The rate of increase in PEP/LVET was minimal below a heart rate of 75 beats per minute. The increase in preejection period at faster heart rates is due to greater isovolumic developed pressure without a corresponding increase in left ventricular dp/dt. Group B consisted of 40 additional patients (20 with atrial fibrillation and 20 with sinus rhythm). In group B, the total electromechanical systole corrected for heart rate (QS2I) and the levels of digoxin in the blood were compared. The QS2I was significantly shorter in atrial fibrillation (497 +/- 5 msec vs 528 +/- 4 msec; P less than 0.01), while the levels of digoxin in the blood were identical (0.9 +/- 0.1 vs 1.0 +/- 0.1 ng/ml). The results of this study must be considered when systolic time intervals are to be employed in patients with atrial fibrillation.
journal_name
Chestjournal_title
Chestauthors
Boudoulas H,Lewis RP,Sherman JA,Bush CA,Dalamangas G,Forester WFdoi
10.1378/chest.74.6.629subject
Has Abstractpub_date
1978-12-01 00:00:00pages
629-34issue
6eissn
0012-3692issn
1931-3543pii
S0012-3692(15)45497-2journal_volume
74pub_type
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