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Improvement of peripheral microcirculation after cardioversion of atrial fibrillation
Author(s) -
Quast Daniel Robert,
Hummel Thomas,
Wutzler Alexander,
Meier Juris Jendrik
Publication year - 2019
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13723
Subject(s) - medicine , peripheral , cardiology , atrial fibrillation , oxygenation , ejection fraction , cardioversion , microcirculation , oxygen saturation , heart failure , oxygen , chemistry , organic chemistry
Background Near‐infrared spectroscopy (NIRS) is a noninvasive method to measure regional tissue oxygenation (rSO 2 ). In patients with atrial fibrillation (AF), cardiac output and endothelial function are altered. Peripheral tissue oxygenation may therefore be reduced. This study aims to describe the peripheral tissue oxygenation of the feet before and after synchronized electrical cardioversion (CV) of patients with AF using NIRS. Methods Patients with AF undergoing CV were included and screened for peripheral arterial disease (PAD), diabetes mellitus (DM), and peripheral neuropathy (PN). NIRS was performed before and after CV under continuous ECG and monitoring of peripheral oxygen saturation. NIRS was registered on the dorsoplantar and plantar area of both feet. Capillary blood gas analysis was performed and left ventricular ejection fraction (LVEF) was determined. Results Twelve patients (five women, seven men, age 70.8 ± 10.8 years) participated. None had history of PAD. DM was present in three (25%) patients. Two patients (16.7%) had PN. CV was successful in 11 patients. Overall, rSO 2 improved significantly in all patients after CV ( P = .0003). Mean improvement was 7.17%. There were no significant changes in body temperature, ankle‐brachial index, sO 2 , pO 2 , pCO 2 , pH, or lactate after CV. Heart rate was significantly lower ( P < .0001) and LVEF significantly higher ( P = .0123) after CV. Conclusions In patients with AF, peripheral tissue oxygen saturation improves significantly after successful CV. This suggests that patients with PAD may not only benefit from interventional or surgical improvement of arterial vascularization, but also from CV in case of AF.