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

Abstract

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 V 0.5–2.0 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.