Electrical cardioversion properties which impact procedure effectiveness in patients with long-acting atrial fibrillation

Irina Pupkevica, Antra Simkevica and Oskars Kalejs

Atrial fibrillation is the most common cardiac arrhythmia. Atrial fibrillation is characterized by high morbidity and mortality. Electrical or pharmacological cardioversion is a standard procedure to restore sinus rhythm. Aim was to evaluate the correlation between the amount of electrical shocks as well as the total energy applied with maintenance of sinus rhythm 30 days after electrical cardioversion. In this prospective study data from 150 patients were collected in Pauls Stradins Clinical University Hospital`s. Questionnaires were administered and follow-up data were collected by phone patient survey from 30 days after ECV.150 patients were questioned – 70% male (n=105) and 30% female (n=45) with a mean age of 65 (56-74) years. Electrical cardioversion was performed to all patients in this study. Sinus rhythm was restored in 145 of patients (96.7%). The success rate after a single discharge was 87.3%. 2 electrical shocks were required for 9.3% of patients and 3.3% of patients benefited from a third shock. A single discharge has a greater success rate for maintaining sinus rhythm for 30 days (p=0.003). In 10% of all patients cardioversion began with 150 J. Initial discharge was 200 J for 76.7% of patients, the total energy applied was 300 J for 6% of patients and 360 J for 3.3% of patients. The success rate for maintaining sinus rhythm for 30 days was greater with higher initial discharges (p=0.004). A successful single discharge and higher total energy applied correlate with more stable sinus rhythm 1 month after electrical cardioversion was performed.

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