Vol 23, No 1 (2019)
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Published online: 2019-01-14

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Restoration of sinus rhythm does not improve peripheral blood flow in hemodynamically stable patients with atrial fibrillation

Eliza Miszkowska- Nagórna1, Jolanta Neubauer-Geryk2, Melanie Wielicka1, Grzegorz Raczak3, Krzysztof Narkiewicz1, Leszek Bieniaszewski2
Arterial Hypertension 2019;23(1):8-13.


Background. Atrial fibrillation (AFib) is the most common atrial tachyarrhythmia with multiple negative hemodynamic
consequences. Although there have been many studies on the effects of AFib on cardiac function, very few
have focused on changes in peripheral circulation during arrhythmia. Therefore, the aim of the present study was to
determine the effect of the reversal of AFib to sinus rhythm (SR) on peripheral blood flow.

Material and methods. The forearm blood flow was determined by strain gauge plethysmography (EC 5R, Hokanson,
Bellevue, USA) in hemodynamically stable 41 patients aged 63 ± 12 years with paroxysmal or persistent AFib.
Venous capacity (VC), venous outflow (VO) and V0.5–2.0 index, arterial inflow (AI) and fast blood flow (FBF) were
measured. 24 patients underwent successful cardioversion. The assessment of peripheral blood flow, BP and HR was
performed during arrhythmia and then replicated within 7 day period after restoring of SR.

Results. At baseline, plethysmographic parameters, heart rate, systolic and diastolic BP did not differ significantly
for patients who underwent successful cardioversion vs. in those who failed to restore SR. Conversion of AFib to SR
did not change values of indices characterizing both venous and arterial vessels, values of systolic and diastolic blood
pressure, whereas heart rate was significantly reduced.

Conclusions. Restoration of sinus rhythm does not improve peripheral blood flow in hemodynamically stable patients
with AFib in short term observation.

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