Journal Article

Low-energy internal cardioversion in patients with long-lasting atrial fibrillation refractory to external electrical cardioversion: results and long-term follow-up

G. Gasparini, A. Bonso, S. Themistoclakis, F. Giada and A. Raviele

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 3, issue 2, pages 90-95
Published in print April 2001 | ISSN: 1099-5129
Published online April 2001 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1053/eupc.2001.0159
Low-energy internal cardioversion in patients with long-lasting atrial fibrillation refractory to external electrical cardioversion: results and long-term follow-up

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Aim

Low-energy internal cardioversion is a new electrical treatment for patients with persistent atrial fibrillation. This paper evaluates the efficacy and safety of low-energy internal cardioversion in patients with long-lasting atrial fibrillation refractory to external electrical cardioversion, and the clinical outcome of such patients.

Method and Results

The study population consisted of 55 patients [32 male, mean age 65±10 years, 48 (87%) with underlying heart disease] with long-lasting (mean 18±34 months) atrial fibrillation in whom external cardioversion had failed to restore sinus rhythm. Two custom-made catheters were used: one positioned in the right atrium and one in the coronary sinus or the left pulmonary artery. A standard catheter was inserted into the right ventricular apex to provide R wave synchronization. Sinus rhythm was restored in 52 patients (95%) with a mean defibrillating energy of 6.9±2.6 J (320±60 V). No complications were observed. During follow-up (mean 18±9 months), 16 patients (31%) suffered early recurrence (≤1 week) of atrial fibrillation and 20 patients (38%) had late recurrence (>1 week, mean 3.5±3.6 months) of atrial fibrillation. Six patients with a late recurrence again underwent cardioversion and five of these maintained sinus rhythm. Therefore, a total of 21/52 patients (40%) were in sinus rhythm at the end of follow-up. No clinical difference was found between patients with and without recurrences.

Conclusions

Low-energy internal cardioversion is a useful means of restoring sinus rhythm in patients with long-lasting atrial fibrillation refractory to external electrical cardioversion. More than one-third of patients maintained sinus rhythm during long-term follow-up.

Keywords: Atrial fibrillation; low-energy internal cardioversion; external cardioversion; atrial defibrillation; clinical outcome

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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