-transparent.png){kind=logo}
OBJECTIVE To investigate the efficacy of internal cardioversion using low energy shocks delivered with a biatrial electrode configuration in chronic atrial fibrillation resistant to transthoracic shocks. METHODS Low energy internal cardioversion was attempted in 11 patients who had been in atrial fibrillation for 233 (SD 193) days and had failed to cardiovert with transthoracic shocks of 360 J in both apex-base and anterior-posterior positions. Synchronised biphasic shocks of up to 400 V (approximately 6 J) were delivered, usually with intravenous sedation only, between high surface area electrodes in the right atrium and the left atrium (coronary sinus in nine, left pulmonary artery in one, left atrium via patent foramen ovale in one). RESULTS Sinus rhythm was restored in 8/11 patients. The mean leading edge voltage of successful shocks was 363 (46) V [4.9 (1.2) J]. Higher energy shocks induced transient bradycardia [time to first R wave 1955 (218) ms]. No proarrhythmia or other acute complications were observed. CONCLUSIONS Low energy internal cardioversion of atrial fibrillation can restore sinus rhythm in patients in whom conventional transthoracic shocks have failed.
S M Sopher, and
F D Murgatroyd, and
A K Slade, and
I Blankoff, and
E Rowland, and
D E Ward, and
A J Camm
February 1999,
Revista espanola de cardiologia,
S M Sopher, and
F D Murgatroyd, and
A K Slade, and
I Blankoff, and
E Rowland, and
D E Ward, and
A J Camm
January 1995,
Journal of cardiovascular electrophysiology,
S M Sopher, and
F D Murgatroyd, and
A K Slade, and
I Blankoff, and
E Rowland, and
D E Ward, and
A J Camm
November 1998,
The American journal of cardiology,
S M Sopher, and
F D Murgatroyd, and
A K Slade, and
I Blankoff, and
E Rowland, and
D E Ward, and
A J Camm
September 1997,
Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing,
S M Sopher, and
F D Murgatroyd, and
A K Slade, and
I Blankoff, and
E Rowland, and
D E Ward, and
A J Camm
October 2004,
Acta cardiologica,
S M Sopher, and
F D Murgatroyd, and
A K Slade, and
I Blankoff, and
E Rowland, and
D E Ward, and
A J Camm
September 1999,
International journal of cardiology,
S M Sopher, and
F D Murgatroyd, and
A K Slade, and
I Blankoff, and
E Rowland, and
D E Ward, and
A J Camm
October 2005,
Indian pacing and electrophysiology journal,
S M Sopher, and
F D Murgatroyd, and
A K Slade, and
I Blankoff, and
E Rowland, and
D E Ward, and
A J Camm
January 2002,
Archivos de cardiologia de Mexico,
S M Sopher, and
F D Murgatroyd, and
A K Slade, and
I Blankoff, and
E Rowland, and
D E Ward, and
A J Camm
December 1997,
Archives des maladies du coeur et des vaisseaux,
S M Sopher, and
F D Murgatroyd, and
A K Slade, and
I Blankoff, and
E Rowland, and
D E Ward, and
A J Camm
September 2003,
Heart (British Cardiac Society),
