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[Double sequential electrical transthoracic shocks for refractory atrial fibrillation]
Enrique Velázquez Rodríguez1, Agustín Martínez Enríquez, Carlos Cancino Rodríguez
1Departamento de Electrofisiología del Hospital de Cardiología, Centro Médico Nacional Siglo XXI, IMSS. enve@prodigy.net.mx
Archivos De Cardiologia De Mexico
|December 22, 2005
Summary
Double sequential transthoracic shocks are a safe and effective alternative for patients with atrial fibrillation resistant to standard cardioversion. This method successfully restored sinus rhythm in 90.4% of patients, with body weight and duration of atrial fibrillation being key factors in success rates.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Context:
- Atrial fibrillation (AF) management relies on effective cardioversion.
- Transthoracic impedance significantly influences cardioversion success.
- Conventional cardioversion may fail in refractory AF cases.
Purpose:
- To evaluate the efficacy and safety of double sequential transthoracic shocks for AF refractory to standard cardioversion.
- To identify factors associated with cardioversion success or failure.
Summary:
- A study involving 21 patients with refractory AF assessed the double sequential transthoracic shock method using 720 J from two defibrillators.
- Sinus rhythm was achieved in 90.4% of patients without major complications.
- Multivariate analysis indicated that longer AF duration (>90 days) and higher body weight were independently associated with cardioversion failure.
Impact:
- Double sequential transthoracic shocks offer a safe and highly effective alternative for refractory AF.
- This approach demonstrates general applicability in clinical settings.
- Understanding predictors of failure can optimize treatment strategies for AF cardioversion.