Key result
Internal atrial cardioversion restores sinus rhythm in ~93% of patients with long-standing AF.
Why the study?
The efficacy of low energy internal atrial cardioversion in restoring sinus rhythm in patients with chronic atrial fibrillation lasting more than 1 year was evaluated.
Does low energy internal atrial cardioversion restore sinus rhythm in patients with chronic atrial fibrillation lasting more than a year?
Does low energy internal atrial cardioversion restore sinus rhythm in patients with chronic atrial fibrillation lasting more than a year?
Internal low energy atrial cardioversion is highly effective for restoring sinus rhythm in patients with long-standing chronic AF, though early recurrences are common and require antiarrhythmic therapy.
Low-energy internal cardioversion restored SR in 93% of >1-year AF cases; supports feasibility but leaves open durability versus external approaches in larger trials.
UNLABELLED: The aim of this study was to evaluate the efficacy of low energy internal atrial cardioversion in restoring sinus rhythm (SR) in patients with chronic atrial fibrillation (AF) persisting > 1 year. Fifteen patients with chronic AF lasting > 1 year (from 13-48 months, mean 24 +/- 13 months) were studied. R wave synchronized 3/3 ms biphasic shocks were delivered between right atrial and coronary sinus (left pulmonary artery in five patients) electrodes. Sedatives or anesthetics were administered only at the patient's request. RESULTS: Stable SR was restored in 14 (93%) of 15 patients after shocks with a mean leading edge voltage of 377 +/- 77 V (range 260-500) and a mean delivered energy of 7.3 +/- 3.4 J (range 2.6-12.9). The procedure was performed without anesthesia in 6 (40%) patients. All successfully cardioverted patients were treated with flecainide, sotalol, or amiodarone. During a follow up of 7.7 +/- 7.9 months (range 1-24) AF recurred in five (36%) patients. Three of five AF recurrences occurred within 3 days after conversion to SR. CONCLUSION: Internal low energy atrial cardioversion is highly effective in restoring SR even in patients with AF lasting > 1 year. The long-term results from the standpoint of freedom from AF recurrences, are satisfactory, although additional antiarrhythmic treatment is required, particularly in the first days after conversion.
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Boriani et al. (1999) studied chronic atrial fibrillation (AF) persisting > 1 year (n=15). Low energy internal atrial cardioversion was evaluated on restoration of stable sinus rhythm. Low energy internal atrial cardioversion successfully restored stable sinus rhythm in 93% of patients with chronic atrial fibrillation lasting more than a year.
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