Abstract

Atrial fibrillation (AF) is the commonest rhythm abnormality. It may occur as paroxysms of irregular tachycardia or more often it becomes established as a permanent condition. The aim of the study was to measure LA (Left Atrial) volume and f (fibrillatory) wave amplitude of ECG (Electrocardiography) in Rheumatic AF.
Methods: 100 cases of Rheumatic AF and 100 patients with normal sinus rhythm without any cardiovascular disease were taken as control in the present study. All the patients were evaluated clinically, by ECG findings, and echocardiographically. LA size was measured by volumetric method (LAVI) and M-mode on echocardiography.
Results:- Out of 100 patients with Rheumatic AF, 32% were males. Mean age of the patients was 41 + 4.47 years in the case group and 31.2 + 5.0 years in control groups. 16 patients had paroxysmal AF, 5 had persistent AF and 79 were found to have permanent AF in the case group. Mean LA size was 4.99 ±1.48 cm by M mode and 35±8.2 ml/m2 by volumetric method in case group and 2.69±0.29 cm and 30±2.4 ml/m2 in control group (p =0.0001). Patients with longer duration of AF (> 5 years) had larger LA size (P< 0.009). Significantly higher number of patients (89%) had LA size >4 cm and volume > 34ml/m2 as compared to the patients having LA size <4 cm and volume < 34ml/m2 in the case group. (x2=10.63, Df=1,P=0.001). It was noted that chronic AF patients had significantly larger fibrillatory waves as compared to paroxysmal AF (x2=5.99,D.F=1,P=0.014). Additionally, f wave of > 1mm reported in patients with LA size>4 cm, and volume> 34 ml/m2