Effect of chronic atrial fibrillation on regional cerebral blood flow.

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Abstract
The development of a non-invasive technique for simultaneous bihemispheric measurement of regional cerebral blood flow (rCBF) by inhalation of 133Xe made available a safe method for evaluation of cerebral circulation under various cardiac conditions. Regional cerebral blood flow was measured by 133Xe inhalation in 31 patients with chronic atrial fibrillation without symptoms of heart failure and free from neurological diseases. Their age ranged from 35-80 (mean 60.3 yr). In 27 of the 31 patients rCBF was lower than for age-matched normal control subjects. A reduction in cerebral blood flow from 17.5 to 5.5% in various age groups was found. The highest reduction in mean rCBF (17.5%) was found in the younger age group (35-50 yr). In the group of patients between 51-65 yr, the reduction was 13.4% and in the patients > 65, only 5.5%. The reduction of rCBF observed in these patients apparently did not reach the level required to produce cerebral manifestations. Any superimposed rhythm or rate pathology and/or cerebral arteriosclerosis may further compromise the cerebral circulation. Although cerebral emboli are a frequent cause of cerebral manifestations in cardiac arrhythmia a chronic reduction in cerebral perfusion consequent to rate or rhythm disturbances in patients with cerebral vascular diseases should be considered. Early recognition and therapy of chronic arrhythmia with reduced cerebral perfusion may prevent neurological complications at a later stage.