Document Detail

Initial experience with a new balloon-guided single lead catheter for internal cardioversion of atrial fibrillation and dual chamber pacing.
MedLine Citation:
PMID:  9990636     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Based on the observation that internal cardioversion (IntCV) of atrial fibrillation is effective with electrodes in the right atrium and pulmonary artery, a new balloon-guided catheter and external defibrillation device with optional dual chamber pacing was evaluated. METHODS: IntCV was attempted in 27 patients (age: 57 +/- 10 years, duration: 14 +/- 18 months, left atrial diameter 56 +/- 8 mm) using a new defibrillation device (Alert, EP MedSystems, Inc., NJ, USA) that allows the delivery of biphasic shocks (0.5-15 J, variable tilt), atrial and ventricular pacing, and online signal recording. Pacing and defibrillation shocks were applied via a 7.5 Fr balloon-guided catheter (EP MedSystems, Inc.). Pacing, sensing, and triggering were established through the proximal atrial array and an electrode ring between both defibrillation arrays and a single ventricular electrode ring. Catheters were inserted from the antecubital vein. RESULTS: In 25 of 27 patients sinus rhythm was restored with a mean energy of 6.7 +/- 4.5 J. In five patients, atrial postshock pacing was required for bradycardia and atrial premature beats. The mean fluoroscopy time was 2.0 +/- 1.3 minutes. CONCLUSION: The high success rate, ease of application, and backup dual chamber pacing suggest that this system is an alternative to established methods of cardioversion. In certain indications, such as failure of prior external cardioversion and situations in which a standard pulmonary balloon catheter is needed, this system would be advantageous.
A Plewan; C Valina; R Herrmann; E Alt
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  22     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1999 Jan 
Date Detail:
Created Date:  1999-04-13     Completed Date:  1999-04-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  228-32     Citation Subset:  IM    
I Medizinische Klinik, Klinikum rechts der Isar, München, Germany.
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MeSH Terms
Atrial Fibrillation / therapy*,  ultrasonography
Balloon Dilatation / instrumentation*
Cardiac Pacing, Artificial / methods
Defibrillators, Implantable*
Echocardiography, Transesophageal
Electric Countershock / methods
Equipment Design
Follow-Up Studies
Heart Catheterization / instrumentation
Middle Aged
Pacemaker, Artificial*
Prosthesis Implantation / methods*
Treatment Outcome

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

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