| Transvenous low energy internal cardioversion for atrial fibrillation: a review of clinical applications and future developments. | |
MedLine Citation:
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PMID: 11227977 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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:
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G Boriani; M Biffi; C Camanini; R M Luceri; A Branzi |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 24 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2001 Jan |
Date Detail:
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Created Date: 2001-02-28 Completed Date: 2001-05-31 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 99-107 Citation Subset: IM |
Affiliation:
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Institute of Cardiology, University of Bologna, Policlinico S. Orsola, Via Massarenti 9, 40138 Bologna, Italy. cardio1@almadns.unibo.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Fibrillation
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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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