Related Experiment Video
Updated: Jun 21, 2026

Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
Electrocardiographic markers of cardioversion success in patients with atrial fibrillation
Basel Al Aloul1, A Selcuk Adabag, Ilknur Can
1Division of Cardiology, Department of Medicine, Veterans Affairs Medical Center, University of Minnesota, Minneapolis, MN 55455, USA. alalo001@umn.edu
Background:
In patients with atrial fibrillation (AF) and atrial flutter (AFL), the value of the 12-lead surface electrocardiogram (ECG) in predicting direct current cardioversion (DCCV) outcomes has not been thoroughly investigated. We sought to determine whether the type of atrial arrhythmia (AF versus AFL) and the characteristics of the atrial fibrillatory waves (fine versus coarse) on the surface ECG would help predict post DCCV outcomes.
Methods:
A total of 76 consecutive patients undergoing elective DCCV for persistent AF or AFL at the Minneapolis Veterans Affairs Medical Center were included in this retrospective cohort study. All patients had ECGs immediately and one month after DCCV.
Results:
Mean age was 67+/-8 years and 97% of the participants were male. DCCV was immediately successful in 64 (84%) patients. Of these, 35 (46%) remained in sinus rhythm at one month. DCCV was immediately successful in all patients (N 13) with fine AF versus 34/45 of those with coarse AF (P 0.05). Patients with fine AF were also more likely to remain in sinus rhythm at one-month follow up compared to those with coarse AF (8/13 versus 13/45; P 0.03). Also, at one-month follow up, the patients with AFL were more likely to maintain sinus rhythm than those with AF (14/18 of AFL versus 21/58 of AF; P 0.003).
Conclusion:
The characteristics of the fibrillatory waves on surface ECG should be utilized to determine the success after DCCV in patients with AF and AFL.
Related Concept Videos
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and the T...
Electrocardiogram Fundamentals
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin to...
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Dysrhythmias V: Evaluating Dysrhythmias
Dysrhythmias IV: Characteristics of Bradyarrhythmias

