Echocardiography and cerebral computed tomography in chronic atrial fibrillation.

Chronic atrial fibrillation (CAF) may be complicated by asymptomatic small silent cerebral infarctions as well as by stroke. The echocardiographic findings in 29 patients with CAF and 29 controls in sinus rhythm are presented. The cerebral computed tomography (CT) findings in these patients were previously published and significantly more small low-density lesions, probably reflecting previous infarctions, were found in patients with CAF than in controls. The aim of the present study was to evaluate if patients with such cerebral lesions had characteristic echocardiographic abnormalities with special reference to patients with CAF. No significant differences could be detected between the groups with and without cerebral lesions regarding the occurrence of valvular heart disease, left ventricular dysfunction, end-diastolic diameter of the left ventricle, left atrial dimension and left ventricular fractional shortening. Only seven patients with CAF (24%) compared with 21 in sinus rhythm (72%) had normal echocardiograms (P less than 0.001). In conclusion, echocardiography gave no guidance to why some patients developed cerebral low-density areas on CT.