Document Detail

Incidence and management of early recurrent atrial fibrillation (ERAF) after transthoracic electrical cardioversion.
MedLine Citation:
PMID:  14697721     Owner:  NLM     Status:  MEDLINE    
AIMS: The purpose was to determine the incidence of early recurrent atrial fibrillation (ERAF) after transthoracic cardioversion (CV) of persistent atrial fibrillation (AF) and to evaluate the efficacy of a predefined strategy for its management. METHODS AND RESULTS: Consecutive patients (n=135) underwent elective CV of AF. CV was performed according to a predefined step-up protocol with rising energy delivery (200 J to 360 J). ERAF was defined as a relapse of AF within 1 min after at least two sinus beats. For proper identification of success of CV, additional endocardial recordings were obtained by an electrode catheter positioned in the high right atrium. In case of ERAF, further CVs were attempted, first with higher energy delivery only, second after intravenous flecainide. If transthoracic CV was ineffective, an internal CV was scheduled. All patients could be converted into sinus rhythm. Sixteen patients (12%) had ERAF. ERAF could be suppressed by further shock delivery in 31% of them. In the remaining 69%, a combination of i.v. flecainide and repeated CV was effective in controlling ERAF. Clinical and echocardiographic parameters were comparable in patients with or without ERAF. CONCLUSION: (1) In the patient population studied, transthoracic CV of AF was technically highly efficacious, so that an internal CV was not necessary in any of the cases. (2) Clinical success of transthoracic cardioversion was limited by ERAF in 12% of the patients. (3) Using the described protocol, ERAF could be suppressed in all patients.
Stephanos Siaplaouras; Jens Jung; Axel Buob; Armin Heisel
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  6     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-30     Completed Date:  2004-06-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  15-20     Citation Subset:  IM    
Medizinische Universitäts- und Poliklinik, Innere Medizin III, Kardiologie/Angiologie, Universitätskliniken des Saarlandes, D-66421 Homburg, Germany.
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MeSH Terms
Anti-Arrhythmia Agents / therapeutic use*
Atrial Fibrillation / drug therapy,  therapy*
Electric Countershock / methods*
Flecainide / therapeutic use*
Injections, Intravenous
Middle Aged
Prospective Studies
Treatment Outcome
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 54143-55-4/Flecainide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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