Skip to main content
NCBI home page
British Medical Journal logoLink to British Medical Journal
. 1970 Aug 8;3(5718):315–318. doi: 10.1136/bmj.3.5718.315

Immediate Effect on Cardiac Output of Reversion to Sinus Rhythm from Rapid Arrhythmias

J S Wright, J Fabian, E J Epstein
PMCID: PMC1701496  PMID: 5451953

Abstract

Cardiac output was estimated immediately before and after conversion to sinus rhythm in nine patients with rapid arrhythmias. Conversion was by synchronized direct-current shock in eight patients, and by direct atrial wall stimulation in the other. In seven patients there was an immediate increase in cardiac output after restoration of sinus rhythm. The percentage increase in output was directly proportional to the rate of the arrhythmia immediately before conversion (r=0·91, P<0·01). The critical heart rate, above which an immediate increase in cardiac output might be expected on conversion to sinus rhythm, appeared in these patients to be about 160 beats per minute.

Full text

PDF
315

Images in this article

315FIG. 4
on p.315

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BRAUNWALD E. SYMPOSIUM ON CARDIAC ARRHYTHMIAS. INTRODUCTION WITH COMMENTS ON THE HEMODYNAMIC SIGNIFICANCE OF ATRIAL SYSTOLE. Am J Med. 1964 Nov;37:665–669. doi: 10.1016/0002-9343(64)90016-6. [DOI] [PubMed] [Google Scholar]
  2. Benchimol A., Ellis J. G., Dimond E. G., Wu T. Hemodynamic consequences of atrial and ventricular arrhythmias in man. Am Heart J. 1965 Dec;70(6):775–788. doi: 10.1016/0002-8703(65)90333-9. [DOI] [PubMed] [Google Scholar]
  3. Benchimol A., Liggett M. S. Cardiac hemodynamics during stimulation of the right atrium, right ventricle, and left ventricle in normal and abnormal hearts. Circulation. 1966 Jun;33(6):933–944. doi: 10.1161/01.cir.33.6.933. [DOI] [PubMed] [Google Scholar]
  4. CHAPMAN C. B., FISHER J. N., SPROULE B. J. Behavior of stroke volume at rest and during exercise in human beings. J Clin Invest. 1960 Aug;39:1208–1213. doi: 10.1172/JCI104136. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Fluck D. C., Olsen E., Pentecost B. L., Thomas M., Fillmore S. J., Shillingford J. P., Mounsey J. P. Natural history and clinical significance of arrhythmias after acute cardiac infarction. Br Heart J. 1967 Mar;29(2):170–189. doi: 10.1136/hrt.29.2.170. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. GRAETTINGER J. S., CARLETON R. A., MUENSTER J. J. CIRCULATORY CONSEQUENCES OF CHANGES IN CARDIAC RHYTHM PRODUCED IN PATIENTS BY TRANSTHORACIC DIRECT-CURRENT SHOCK. J Clin Invest. 1964 Dec;43:2290–2302. doi: 10.1172/JCI105103. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Halmos P. B., Patterson G. C. Effect of atrial fibrillation on cardiac output. Br Heart J. 1965 Sep;27(5):719–723. doi: 10.1136/hrt.27.5.719. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Ikram H., Nixon P. G., Arcan T. Left atrial function after electrical conversion to sinus rhythm. Br Heart J. 1968 Jan;30(1):80–83. doi: 10.1136/hrt.30.1.80. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. KAHN D. R., WILSON W. S., WEBER W., SLOAN H. HEMODYNAMIC STUDIES BEFORE AND AFTER CARDIOVERSION. J Thorac Cardiovasc Surg. 1964 Dec;48:898–905. [PubMed] [Google Scholar]
  10. Killip T., Baer R. A. Hemodynamic effects after reversion from atrial fibrillation to sinus rhythm by precordial shock. J Clin Invest. 1966 May;45(5):658–671. doi: 10.1172/JCI105381. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. LOGAN W. F., ROWLANDS D. J., HOWITT G., HOLMES A. M. LEFT ATRIAL ACTIVITY FOLLOWING CARDIOVERSION. Lancet. 1965 Sep 4;2(7410):471–473. doi: 10.1016/s0140-6736(65)91427-3. [DOI] [PubMed] [Google Scholar]
  12. LOWN B., AMARASINGHAM R., NEUMAN J. New method for terminating cardiac arrhythmias. Use of synchronized capacitor discharge. JAMA. 1962 Nov 3;182:548–555. [PubMed] [Google Scholar]
  13. MORRIS J. J., Jr, ENTMAN M., NORTH W. C., KONG Y., MCINTOSH H. THE CHANGES IN CARDIAC OUTPUT WITH REVERSION OF ATRIAL FIBRILLATION TO SINUS RHYTHM. Circulation. 1965 May;31:670–678. doi: 10.1161/01.cir.31.5.670. [DOI] [PubMed] [Google Scholar]
  14. ORAM S., DAVIES J. P., WEINBREN I., TAGGART P., KITCHEN L. D. Conversion of atrial fibrillation to sinus rhythm by direct-current shock. Lancet. 1963 Jul 27;2(7300):159–162. doi: 10.1016/s0140-6736(63)92799-5. [DOI] [PubMed] [Google Scholar]
  15. REALE A. ACUTE EFFECTS OF COUNTERSHOCK CONVERSION OF ATRIAL FIBRILLATION UPON RIGHT AND LEFT HEART HEMODYNAMICS. Circulation. 1965 Aug;32:214–222. doi: 10.1161/01.cir.32.2.214. [DOI] [PubMed] [Google Scholar]
  16. REEVES J. T., GROVER R. F., BLOUNT S. G., Jr, FILLEY G. F. Cardiac output response to standing and treadmill walking. J Appl Physiol. 1961 Mar;16:283–288. doi: 10.1152/jappl.1961.16.2.283. [DOI] [PubMed] [Google Scholar]
  17. RUSHMER R. F. Constancy of stroke volume in ventricular responses to exertion. Am J Physiol. 1959 Apr;196(4):745–750. doi: 10.1152/ajplegacy.1959.196.4.745. [DOI] [PubMed] [Google Scholar]
  18. Rodman T., Pastor B. H., Figueroa W. Effect on cardiac output of conversion from atrial fibrillation to normal sinus mechanism. Am J Med. 1966 Aug;41(2):249–258. doi: 10.1016/0002-9343(66)90020-9. [DOI] [PubMed] [Google Scholar]
  19. Ross J., Jr, Linhart J. W., Brauwald E. Effects of changing heart rate in man by electrical stimulation of the right atrium. studies at rest, during exercise, and with isoproterenol. Circulation. 1965 Oct;32(4):549–558. doi: 10.1161/01.cir.32.4.549. [DOI] [PubMed] [Google Scholar]
  20. SALTIN B., STENBERG J. CIRCULATORY RESPONSE TO PROLONGED SEVERE EXERCISE. J Appl Physiol. 1964 Sep;19:833–838. doi: 10.1152/jappl.1964.19.5.833. [DOI] [PubMed] [Google Scholar]
  21. SELDINGER S. I. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta radiol. 1953 May;39(5):368–376. doi: 10.3109/00016925309136722. [DOI] [PubMed] [Google Scholar]
  22. Scott M. E., Patterson G. C. Cardiac output after direct current conversion of atrial fibrillation. Br Heart J. 1969 Jan;31(1):87–90. doi: 10.1136/hrt.31.1.87. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Shapiro W., Klein G. Alterations in cardiac function immediately following electrical conversion of atrial fibrillation to normal sinus rhythm. Circulation. 1968 Dec;38(6):1074–1084. doi: 10.1161/01.cir.38.6.1074. [DOI] [PubMed] [Google Scholar]
  24. Turner J. R., Towers J. R. Complications of cardioversion. Lancet. 1965 Sep 25;2(7413):612–614. doi: 10.1016/s0140-6736(65)90518-0. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES