Enlarged Left Atrium Consideration

I understand that for those with afib, an enlarged left atrium is a possibility. Questions:

Does this condition happen over months, a year, or years? I'm guessing severity of afib is a big factor but can you give a general time frame?

If it is enlarged, does it ever go back to normal without medical intervention?

Are there symptoms that a person can feel if the atrium is enlarged?

If it is enlarged, what then?

Much appreciation for your time on this board,

Ross I.

[CCF-M.D.-MJM]

Hi Ross,

We asked the same questions last week at a meeting and aren't exactly sure of the answers.  It is true that people with AF tend to have larger atriums and the larger the atrium, the more difficult it is treat with ablation and the higher the risk of stroke.  It probably occurs of years.

We are going to look at CT scans 3 month post AF ablation to see if there is any difference in size.  We suspect this is, but we have to prove it first.

There are no specific symptoms someone with an enlarged atrium has over someone that doesn't.  If there are symptoms, it would relate more to the reason why the atrium is enlarged (increased intracardiac pressures) rather than the enlarged atrium itself.

If it is enlarged, you have to determine if there is a reason like a leaking mitral valve or stenotic mitral valve.  Any mechanical reason (valvular) is potentially fixable.  If it is from atrial fibrillation, it is not clear yet if rate control or rhythym control of the AF is the best way to apprach this.  There are studies to support both approaches.  If you are having symptomatic atrial fibrillation despite medical therapy, that pushes you more toward the catheter based ablation procedures.

I hope this helps.  Thanks for posting.

[mevi]

A related discussion, left atrium enlargement was started.

[Paty02]

A related discussion, Enlarged left atria was started.