Related Experiment Videos
Initial energy for elective external cardioversion of persistent atrial fibrillation
J A Joglar1, M H Hamdan, K Ramaswamy
1Department of Internal Medicine (Cardiology, Clinical Cardiac Electrophysiology), The University of Texas Southwestern Medical Center, Dallas, Texas 75235-9047, USA.
The American Journal of Cardiology
|August 3, 2000
Summary
Higher energy levels significantly improve direct-current cardioversion success rates for persistent atrial fibrillation. A 360 joule (J) setting demonstrated superior efficacy, requiring fewer shocks and less total energy compared to 100 J or 200 J.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Persistent atrial fibrillation is a common arrhythmia.
- Direct-current cardioversion is a standard treatment.
- Optimal energy settings for cardioversion require further investigation.
Purpose of the Study:
- To evaluate the safety and efficacy of three direct-current cardioversion energy levels (100, 200, and 360 J).
- To determine the most effective energy setting for restoring normal sinus rhythm in patients with persistent atrial fibrillation.
Main Methods:
- Prospective randomized study design.
- Inclusion of patients undergoing elective direct-current cardioversion for persistent atrial fibrillation.
- Comparison of initial success rates and total energy requirements across 100 J, 200 J, and 360 J settings.
Main Results:
- The initial success rate for direct-current cardioversion was significantly higher with 360 J (95%) compared to 100 J (14%) and 200 J (39%).
- Patients treated with 360 J required less total energy and fewer shocks.
- No significant safety concerns were reported across the energy levels.
Conclusions:
- 360 J is a highly effective energy level for elective direct-current cardioversion of persistent atrial fibrillation.
- Higher energy settings improve cardioversion success and reduce the need for multiple shocks.
- The 360 J setting offers an improved therapeutic option for atrial fibrillation management.