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Titolo:
HIGH-ENERGY TRANSCATHETER CARDIOVERSION FOR CHRONIC, POORLY TOLERATEDATRIAL-FIBRILLATION
Autore:
FORGIONE NF; ACQUATI F; CAICO SI; SAVERI S; VERNA E; TAGLIAGAMBE L; REPETTO S;
Indirizzi:
OSPED MULTIZONALE,DIV CARDIOL,VIALE BORRI 57 I-21100 VARESE ITALY GEN HOSP VARESE,DIV CARDIOL VARESE ITALY
Titolo Testata:
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
fascicolo: 7, volume: 19, anno: 1996,
pagine: 1049 - 1052
SICI:
0147-8389(1996)19:7<1049:HTCFCP>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
ATRIOVENTRICULAR JUNCTION; CATHETER ABLATION;
Keywords:
CHRONIC ATRIAL FIBRILLATION; HIGH ENERGY TRANSCATHETER CARDIOVERSION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
12
Recensione:
Indirizzi per estratti:
Citazione:
N.F. Forgione et al., "HIGH-ENERGY TRANSCATHETER CARDIOVERSION FOR CHRONIC, POORLY TOLERATEDATRIAL-FIBRILLATION", PACE, 19(7), 1996, pp. 1049-1052

Abstract

Between August 1991 and May 1993, 14 patients affected by chronic, poorly tolerated atrial fibrillation (AF) were submitted to high energy transcatheter cardioversion. Mean duration of AF was 27.4 +/- 45.1 months. In nine patients (56%), AF lasted for > 1 year. All patients had underlying heart disease, with a mean LVEF of 45.2% +/- 11.8% and a NYHA Class greater than or equal to II. Previously, a mean of 2.9 +/- 1.3 patients failed external electrical cardioversion, with and without antiarrhythmics, have been attempted. Transcatheter conversion was performed by pulling the His-bundle catheter back in the right atrial cavity until no His bundle activity was recorded on distal poles, and then delivering the shock between a proximal electrode (cathode) and a back plate (anode). In all patients, transcatheter conversion restored sinus rhythm. Transient complete atrioventricular (AV) block was observed in four patients (28%), and treated by prophylactic temporary pacing. At 1 year seven patients (50%) were still in sinus rhythm. In this series, only younger age could be related to AF recurrence (46.1 +/- 10.8 vs 63.4 +/- 6.8 years, P less than or equal to 0.004), even if prophylaxis with amiodarone showed a positive trend versus sinus rhythm maintenance (71% vs 14%, P = NS). in conclusion, high energy transcatheter cardioversion is a safe and effective method of restoring sinus rhythm in patients with chronic, poorly tolerated AF. In these patients,high energy transcatheter cardioversion could be considered as an alternative to AV node ablation techniques, avoiding pacemaker implant and embolic risk. Larger studies are needed to determine better patient selection and delineate drug strategy after the procedure.

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Documento generato il 04/04/20 alle ore 21:36:58