What causes breathlessness despite having sinus rhythm restoration?
I would explain as follows:
Welcome on HCM!
I understand your concern and would like to explain that there are several reasons why your breathlessness episodes seem not to be completely gone after your sinus rhythm restoration.
First of all I would explain that atrial fibrillation impairs the normal atrial contribution on blood flow toward the left ventricle and as a consequence has adverse implications on pulmonary physiology and cardiac output.
That's why you have experienced that shortness of breath during atrial fibrillation presence.
But even after conversion of atrial fibrillation to normal sinus rhythm atrial muscle remains stunned for a few days and hence there is no immediate improvement in blood flow.
This is a reason why you don't see a prompt improvement.
Another reason is the primary health disorder that led to atrial fibrillation.
It may be a cardiomyopathy (with systolic and/or diastolic dysfunction).
In such case a cardiac ultrasound would be very informative in clarifying a responsible cardiac dysfunction in dyspnea occurrence.
Also other reasons like hypertension, thyroid dysfunction, a chronic or acute inflammation, etc. may have a concomitant contribution.
If you have any available medical tests reports, you may upload them here for a direct review and a second professional opinion.
I remain at your disposal whenever you need.
Feel free to ask me again in case of further uncertainties.
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