Document Detail


Transvenous low energy internal cardioversion for atrial fibrillation: a review of clinical applications and future developments.
MedLine Citation:
PMID:  11227977     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Low energy internal atrial cardioversion can be performed by delivering biphasic shocks between transvenous catheters positioned within the cardiac chambers or great vessels. Delivery of shocks results in effective cardioversion at energies < 6-10 J and the procedure can be effective even when external cardioversion has failed. Shock induced discomfort varies from patient to patient, but the procedure can be usually performed without general anesthesia and eventually under mild sedation. Nevertheless, tolerability has to be improved by obtaining a substantial reduction in defibrillating thresholds. With regard to safety, delivery of shocks for defibrillating the atria implies a potential risk of inducing ventricular fibrillation; to minimize this risk, shock delivery must be synchronous to the QRS and should be avoided during rapid RR cycles (< 300 ms). Presently, transvenous low energy cardioversion is an investigational procedure, but a widening of indications is expected in the near future. The cost of the procedure, which remains invasive and requires a brief hospital stay, must be balanced with the benefit of restoring sinus rhythm and the possibility of maintaining sinus rhythm for the medium- to long-term. Experimental and clinical investigations of low energy internal cardioversion have resulted in the development of devices for atrial defibrillation whose clinical role and cost-benefit ratio is currently under evaluation.
Authors:
G Boriani; M Biffi; C Camanini; R M Luceri; A Branzi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  24     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-02-28     Completed Date:  2001-05-31     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  99-107     Citation Subset:  IM    
Affiliation:
Institute of Cardiology, University of Bologna, Policlinico S. Orsola, Via Massarenti 9, 40138 Bologna, Italy. cardio1@almadns.unibo.it
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / therapy*
Cost-Benefit Analysis
Costs and Cost Analysis
Electric Countershock / economics,  methods*
Electrophysiologic Techniques, Cardiac
Heart Catheterization
Humans

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


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