Figure 4
Pulsed wave (PW) Doppler images of the right atrial appendage pre (A) and post cardioversion (B) and left atrial appendage pre (C) and post cardioversion (D). Alternating amplitudes of Doppler velocities (white arrows) corresponding to mechanical atrial contraction following atrial flutter waves (yellow arrows) are shown pre cardioversion in right (A) and left atrial appendage (C). Doppler velocity amplitudes (white arrows) corresponding to mechanical atrial contraction following electrical atrial P wave (yellow arrows) returned to normal post cardioversion in both right (B) and left atrial appendage (D). Mitral inflow PW Doppler showing minimal atrial mechanical contraction velocities (white arrows) following flutter waves preceding each QRS complex (yellow arrows) pre cardioversion (E) F) Mitral inflow PW Doppler post cardioversion showing presence of mechanical atrial contraction (white arrows) following atrial P waves (yellow arrows), however there is E and A approximation due to first degree AV block and relative increased heart rate of 80 bpm.