ASSESSMENT OF LEFT VENTRICULAR DIASTOLIC FUNCTION IN PATIENTS WITH ATRIAL FIBRILLATION

* An L-wave is very often an unnoticed finding in the echo laboratory .*A pathologic L-wave typically is found in patients with delayed active relaxation with increased left ventricular stiffness. In the echo laboratory patients will often have advanced diastolic dysfunction with elevated filling pressures and may be systolic dysfunction as well.* It is not known whether this mid-diastolic flow (L-wave) is one of the compensatory mechanisms in the course of left ventricular diastolic dysfunction and diastolic heart failure or just a sign .Recommendation:We recommend further studies on larger sectors of patients to assess the diagnostic and prognostic values of mitral L-wave in patients with chronic non-valvular atrial fibrillation .Further studies using the L’ wave may be an especially useful marker of abnormal LV filling at faster heart rates when the L wave is masked by the shortened period of diastasis..