Journal Article

The effect of endocardial defibrillator shocks on basic atrial electrophysiology in man

N. Sulke, P. Spurrell, K. Kamalvand, A. Mitchell, M. Higson, J. Gill and V. Paul

in EP Europace

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

Volume 5, issue 1, pages 33-37
Published in print January 2003 | ISSN: 1099-5129
Published online January 2003 | e-ISSN: 1532-2092 | DOI:
The effect of endocardial defibrillator shocks on basic atrial electrophysiology in man

Show Summary Details



To determine the effect of an endocardial DC shock on the basic electrophysiology of the human atrium if delivered in sinus rhythm.

Methods and results

A 5J endocardial R wave synchronized DC shock was delivered in 10 patients in stable sinus rhythm during ICD implantation for ventricular arrhythmias. There was no prior history of atrial fibrillation. Monophasic action potential duration (APD) and atrial effective refractory periods (AERP) were evaluated before, 1 min post DC shock, and 15 min post shock. These parameters were assessed at basic cycle lengths and at atrial paced cycle lengths of 600 ms and 400 ms at two right atrial sites; mid lateral right atrial wall (MRLA) and the right atrial appendage (RAA). There were no significant differences in APD 90, AERP or atrial refractory dispersion at any site or drive cycle length before, immediately after or 15 min after shock delivery.


There are no significant changes in basic electrophysiological parameters following a DC shock delivered in sinus rhythm in patients with no prior history of atrial fibrillation. This suggests that atrial electrical remodelling occurs as a result of atrial fibrillation and is unrelated to shock artefact.

Keywords: Atrial fibrillation; atrial electrical remodelling; DC cardioversion; monophasic action potentials; atrial effective refractory period

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.