Myocardial relaxation in atrial fibrillation

Although myocardial contractility has been known to vary from beat to beat in atrial fibrillation, myocardial relaxation in this arrhythmia has not been investigated. In this study, left ventricular relaxation was examined in seven patients with atria! fibrillation (four with mitral valve disease, one with aortic regurgitation, one with secundum type atrial septa! defect and one with apical left ventricular hypertrophy). The left ventricular pressure was measured with a micromanometer-tipped catheter and the time constant of isovolumic left ventricular pressure decline (the relaxation time constant) was calculated by means of exponential curve fitting from more than 20 consecutive beats in each patient.The maximal rate of rise of left ventricular pressure (dP/dt) and the relaxation time constant were examined in relation to the preceding RR interval (RR2) and to the ratio of the RR2interval to the pre-preceding RR interval (RR2/RR1), and the correlation coefficients were obtained. The dP/dt correlated better with RR2/RR1than with the RR2interval (0.82 ± 0.05 versus 0.48 ± 0.2), but the relaxation time constant did not show any correlation with RR2/RR1or the RR2interval (0.03 ± 0.21 and 0.06 ± 0.21, respectively). The relaxation time constant was fairly constant in each patient even when the RR2interval and RR2/RR1varied greatly.Thus, relaxation in atrial fibrillation is independent of changes in contractility as seen in the relation between postextrasystolic relaxation and postextrasystolic potentiation of contractility