Intracardiac low-energy versus transthoracic high-energy direct-current cardioversion of atrial fibrillation: a randomised comparison.

Jens Friberg, Niels Gadsbøll

Journal: Cardiology 2003;99(2):72-7

PMID: 12711881

Full Text on S. Karger AG, Basel, Switzerland View on PubMed

Abstract

Of 54 patients with long-standing atrial fibrillation (mean duration 8.3 months), 27 patients were randomised to transvenous low-energy intracardiac biphasic direct-current (DC) cardioversion (ICV) using a single-lead balloon-tipped catheter, and 27 patents were randomised to conventional high-energy transthoracic monophasic DC cardioversion (TCV). ICV was performed with increasing energy levels (7.5-10-12.5-15 J) during mild sedation. TCV was performed with 200-360-360 J during general anaesthesia. Cardioversion to sinus rhythm occurred in 93% (25/27) following ICV and in 67% (18/27) following TCV (p = 0.04). Due to the higher cardioversion rate following ICV, more patients were in sinus rhythm during 180 days of follow-up (log rank test, p = 0.04). Low-energy intracardiac cardioversion represents a highly efficacious alternative to high-energy transthoracic cardioversion.

Address: Department of Cardiovascular Medicine, Bispebjerg University Hospital, Copenhagen, Denmark. [email protected]

DOI: 10.1159/000069724

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MeSH Terms: Aged, Amiodarone, Anti-Arrhythmia Agents, Atrial Fibrillation, Biomarkers, Creatine Kinase, Electric Countershock, Female, Follow-Up Studies, Heart Conduction System, Humans, Male, Middle Aged, Propafenone, Random Allocation, Recurrence, Severity of Illness Index, Sotalol, Time Factors, Treatment Outcome, Troponin T