Atrial activation occurring immediately after successful cardioversion of atrial fibrillation

Pacing and Clinical Electrophysiology : PACE
Arturo Martín Peñato MolinaPaula Awamleh

Abstract

Electrical defibrillation is very effective in interrupting atrial fibrillation (AF). However, its mechanism is not completely understood. We report our observations in patients subjected to external electriocardioversion (ECV) of atrial fibrillation and contrast them with recent theories about defibrillation mechanism. In 13 consecutive patients transthoracic electrical cardioversion for AF was performed during an electrophysiological study (11 monophasic -200-360 J- and 9 biphasic shocks -50-150 J-). About 10-16 electrograms were obtained with multipolar catheters recording right atrium, coronary sinus, and right pulmonary artery. AF was defined by interelectrogram intervals and changing sequences among recordings, indicating complete lack of organization. We evaluated the presence of propagated activations immediately (<300 ms) after successful shocks (>or=1 discrete electrogram in all recordings). In unsuccessful shocks we evaluated changes in electrogram morphology (discrete/fragmented) and interelectrogram intervals before and after defibrillation. About 16/20 shocks terminated AF. In 6/16 one or two cycles of atrial activation were recorded just after the shock and before AF ended. In 10/16 AF was interrupted immediately...Continue Reading

References

Jul 1, 1975·The American Journal of Cardiology·D P ZipesW W Jolly
Feb 18, 1997·Circulation·R A GrayJ Jalife
Nov 26, 1999·Circulation Research·Y ChengI R Efimov
Sep 2, 2000·Journal of Cardiovascular Electrophysiology·I R EfimovP J Tchou
Aug 22, 2003·Journal of Cardiovascular Electrophysiology·Natalia A TrayanovaJames C Eason
Apr 19, 1956·The New England Journal of Medicine·P M ZOLLL R NORMAN
Feb 1, 1964·American Heart Journal·G K MOEJ A ABILDSKOV
Apr 27, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Xiangsheng ZhengRaymond E Ideker

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