Drop in Ejection Fraction during afib

Due to the lack of pre-loading of the ventricles, a reduction in ejection fraction when in AF, seems inevitable.
I just had my first echo done while I was in AF and I had about a 9% drop in EF.
I found a older research paper where 30 subjects in AF were echoed both in AF and then in sinus rhythm.
The increase in stroke volume ranged between 30-50% when in SR.

I have been in constant AF since April, so at this point I'm sure my atria are in complete fatigue and are making no
contribution to pre-loading the ventricles. I can tell my endurance has slipped a bit, but no more than when I had paroxysmal episodes in the past.

I have an EP appointment to discuss these results next week.

Yes, when you go into constant afib it wrecks your heart. It did the same with mine, which is why I opted finally for an ablation. When you get back in rhythm, it will most likely go back to normal.

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jpeters
Yes, when you go into constant afib it wrecks your heart. It did the same with mine, which is why I opted finally for an ablation. When you get back in rhythm, it will most likely go back to normal.

This happened to me the week leading up to me changing meds back in April when I went in to continuous AF for 6 days before I could get cardioverted. During the TEE they noted possible damage as well as a decreased ejection fraction. Both of which returned to normal.



Edited 1 time(s). Last edit at 08/16/2018 06:27PM by rocketritch.

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LarryZ
I have been in constant AF since April

I hope you're taking a rate control med. Prolonged tachycardia can cause heart enlargement and eventually heart failure. Although heart failure might resolve once the afib is stopped, there's no guarantee of that. I know people with permanent heart failure caused by prolonged, uncontrolled afib.

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jpeters
Yes, when you go into constant afib it wrecks your heart. It did the same with mine, which is why I opted finally for an ablation. When you get back in rhythm, it will most likely go back to normal.

What goes back to normal, Not an enlarged left atrium? Im not sure how an enlarged heart and thicker lining of the heart go back to normal.

This is why rate Control is so important. The closer you can get your AF HR to your NSR HR the better. Lower AF HR corresponds with more time for the Ventricals to fill with Blood. My EF was measured many times as part of the TEE/ECV process in addition to routine Echos, and my EF only dropped about 5% while I was in AFIB versus NSR. I was able to control my AF HR at about 70.



Edited 3 time(s). Last edit at 08/16/2018 09:42PM by The Anti-Fib.

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hwkmn05

Yes, when you go into constant afib it wrecks your heart. It did the same with mine, which is why I opted finally for an ablation. When you get back in rhythm, it will most likely go back to normal.
What goes back to normal, Not an enlarged left atrium? Im not sure how an enlarged heart and thicker lining of the heart go back to normal.

It is possible to recover from Heart Failure and enlarged LA if it's due to Tachy-Cardia. I went from 20% EF to 70% over the course of 18 months.

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hwkmn05

Yes, when you go into constant afib it wrecks your heart. It did the same with mine, which is why I opted finally for an ablation. When you get back in rhythm, it will most likely go back to normal.
What goes back to normal, Not an enlarged left atrium? Im not sure how an enlarged heart and thicker lining of the heart go back to normal.

Yes, ejection went back up and heart contracted (biatrial enlargement).



Edited 1 time(s). Last edit at 08/16/2018 09:54PM by jpeters.

Heart failure can improve, and it can also not improve. I wouldn't count on it doing so.

I guess I will ask the new EP that question next week. I was told by the outgoing EP 2 years ago my left atrium was enlarged and the cause of my afib. Though the episodes are now rare, last one 15 months ago, I still experience shortness of breath periodically with moderate physical exertion.
I believe thats one sign of enlargement.

Filling adds a component but the ejection fraction drop risk is higher the longer your rate is fast and chaotic. The ventricle gets tired. That may come back with rate control.
Atrial enlargement is also affected by valve regurgitation.