Document Detail

Low-energy intracardiac shocks during atrial fibrillation: effects on cardiac rhythm.
MedLine Citation:
PMID:  9006297     Owner:  NLM     Status:  MEDLINE    
The effect on ventricular rate of intracardiac shocks for atrial fibrillation was studied in 13 patients receiving 95 shocks. Shocks were synchronized to the R wave and were delivered after R-R intervals > 500 msec, with increasing strength (20 to 400 V). In 10 patients, conversion to sinus rhythm was achieved in this way. Noneffective shocks increased the mean first postshock R-R interval (compared with 20 V as baseline), for shocks > or = 140 V. The R-R prolongation correlated with the shock level (r = 0.936, p < 0.01). Subsequent R-R intervals were comparable to baseline. A similar trend toward longer first postshock intervals was observed for effective shocks. However, the maximal first R-R interval after noneffective shocks had no relation to the voltage. The number of pauses > 1500 msec tended to increase with voltage (noneffective shocks). Pauses > 2500 msec were exceptional (4 of 85 noneffective shocks). No symptomatic bradycardia occurred. In subsequent intervals (cycles 2 through 10) no pauses > 2500 msec were noted. It is concluded that atrial defibrillation attempts between the right atrium and coronary sinus prolong R-R intervals, in relation to administered energy, but without the need for backup pacing.
N Gjorgov; F Provenier; L Jordaens
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  133     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-02-11     Completed Date:  1997-02-11     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  101-7     Citation Subset:  AIM; IM    
Department of Cardiology, University Hospital Ghent, Belgium.
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MeSH Terms
Atrial Fibrillation / physiopathology*,  therapy*
Bradycardia / etiology
Electric Countershock / adverse effects,  methods*
Heart Rate*
Middle Aged
Treatment Outcome

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