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Updated: Sep 17, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Strategies for optimizing efficacy of electrical cardioversion of atrial fibrillation
Sahil Bharwani1, Mina K Chung2, Daniel P Morin3
1Ochsner Medical Center, New Orleans, LA, United States of America.
Abstract:
Direct current cardioversion (DCCV) is a cornerstone in the management of atrial fibrillation (AF) and is the quickest way to convert AF to sinus rhythm. Overall, the procedure is effective and safe, but the efficacy of DCCV can be reduced due to modifiable and non-modifiable patient characteristics, or procedural factors. Additionally, inadequate preparation, such as a lack of QRS-synchronization or omitting preprocedural imaging of the left atrial appendage (LAA), could lead to significant harm. This manuscript discusses a brief history of electrical cardioversion, the currently available cardioverter settings/configuration with the highest success rate, the common barriers to successful cardioversion, strategies to overcome these barriers, and suggested protocols to ensure a high level of patient safety.
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