Objectives .– The conduct of anticoagulation in paroxysmal atrial fibrillation is still disputed based on scores adopted by learned societies. Can we rely on echocardiographic study of atrial function to decide of the anticoagulation? Is the left atrial function retained when the arrhythmia is paroxysmal?

Patients and methods .– The prospective study includes 31 patients suffering from heart disease. All patients were undergoing a transthoracic echocardiography. The goal was to compare atrial function in patients with paroxysmal atrial fibrillation history (AF+) and patients with sinusal rhythm (FA−).

Results .– The average age of patients was 55.24 ± 15 years (range: 12 years, 90 years). Nine patients had a history of paroxysmal AF. The (AF+) group had a significantly dilated left atrium (max Vol: 110.5 ml vs. 48.67 mL, P < 0.0001) and left atrial systolic function is more impaired (left atrial ejection fraction: 27.8% vs. 58.8%, P = 0.003). There was no significant difference between the two groups concerning the ejection fraction of LV systolic ( P = 0.12). The peak velocity of systolic wave at mid lateral wall of the left atrium is significantly lower in (AF + ) group (11.26 vs. 13.89 cm/s, P = 0.05), while the wave velocity at septal wall was similar in the two groups ( P = 0.18). The velocity of the (E) wave (114.61 vs. 80.14, P = 0.02), and the ratio E/Ea (lat) (8.71 vs. 5.09, P = 0.01) was significantly higher in patients with history of AF than other patients.

Conclusion .– Our results demonstrate the alteration of the atrial function even if the atrial fibrillation is paroxystic. However, the echocardiographic study of atrial function is not of common practice although it allows in some cases to impose an oral anticoagulant and to prevent.