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[Low energy transcatheter atrial defibrillation in one patient with refractory atrial fibrillation]
R Asenjo1, R Morris, M Llancaqueo
1Centro Nacional de Arritmias, Hospital Clínico U. de Chile.
Insights
Refractory atrial fibrillation can be treated with internal transcatheter defibrillation. A 50-year-old male with persistent atrial fibrillation achieved sinus rhythm using this novel approach, maintaining it at two months.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Atrial fibrillation (AF) is a common arrhythmia.
- Pharmacological and external electrical cardioversion are standard treatments for AF.
- Refractory cases may require advanced interventions.
Observation:
- A 50-year-old male presented with a one-year history of AF.
- The patient was refractory to antiarrhythmic medications.
- External cardioversion was unsuccessful.
Findings:
- Internal transcatheter defibrillation was performed using a bifasic shock of 10 joules.
- The shock was delivered between catheters placed in the right atrium and coronary sinus.
- Successful conversion to sinus rhythm was achieved.
Implications:
- Internal transcatheter defibrillation offers a viable alternative for refractory AF.
- This minimally invasive technique can restore normal heart rhythm.
- Long-term maintenance of sinus rhythm was observed post-procedure.
Abstract:
Most cases of atrial fibrillation are converted with antiarrhythmic medications or external electric defibrillation. However, in some refractory patients, an internal transcatheter defibrillation must be attempted. We report a 50 years old male with an atrial fibrillation of one year duration that was refractory to pharmacological treatment and in whom external cardioversion was unsuccessful. After the application of a bifasic shock of 10 joules between a catheter in the right atrium and another one located at the coronary sinus, the patient was converted to sinus rhythm. At two months of follow up, the patient continues in sinus rhythm.