Document Detail


Low energy internal cardioversion of atrial fibrillation resistant to transthoracic shocks.
MedLine Citation:
PMID:  8697172     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the efficacy of internal cardioversion using low energy shocks delivered with a biatrial electrode configuration in chronic atrial fibrillation resistant to transthoracic shocks. METHODS: Low energy internal cardioversion was attempted in 11 patients who had been in atrial fibrillation for 233 (SD 193) days and had failed to cardiovert with transthoracic shocks of 360 J in both apex-base and anterior-posterior positions. Synchronised biphasic shocks of up to 400 V (approximately 6 J) were delivered, usually with intravenous sedation only, between high surface area electrodes in the right atrium and the left atrium (coronary sinus in nine, left pulmonary artery in one, left atrium via patent foramen ovale in one). RESULTS: Sinus rhythm was restored in 8/11 patients. The mean leading edge voltage of successful shocks was 363 (46) V [4.9 (1.2) J]. Higher energy shocks induced transient bradycardia [time to first R wave 1955 (218) ms]. No proarrhythmia or other acute complications were observed. CONCLUSIONS: Low energy internal cardioversion of atrial fibrillation can restore sinus rhythm in patients in whom conventional transthoracic shocks have failed.
Authors:
S M Sopher; F D Murgatroyd; A K Slade; I Blankoff; E Rowland; D E Ward; A J Camm
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  75     ISSN:  1355-6037     ISO Abbreviation:  Heart     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1996-09-05     Completed Date:  1996-09-05     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  635-8     Citation Subset:  AIM; IM    
Affiliation:
St George's Hospital, London.
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MeSH Terms
Descriptor/Qualifier:
Adult
Atrial Fibrillation / therapy*
Electric Countershock / adverse effects,  methods*
Female
Humans
Male
Middle Aged
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