Use of biphasic electrical cardioversion for treatment of idiopathic atrial fibrillation in two horses

Rectilinear biphasic cardioversion was used in 2 horses with idiopathic sustained atrial fibrillation; 1 horse converted to sustained sinus rhythm. Variables that potentially affected outcome of the electrical cardioversion procedures in these horses included duration of arrhythmia, placement of cardioverter pads and paddles, serum electrolyte concentrations, and treatment with quinidine. Serum cardiac troponin I concentration, measured to determine whether the myocardium was damaged from the electrical shocks, was within the reference range in both horses after the procedure. Biphasic electrical cardioversion may provide an alternative to pharmacologic cardioversion with quinidine in horses. The rectilinear biphasic defibrillator-cardioverter uses a unique biphasic waveform to deliver constant current to the myocardium during cardioversion, regardless of transthoracic impedance. Biphasic cardioversion is safer and more effective than traditional monophasic cardioversion in humans and animals.