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Heart 1998;79:128-132; doi:10.1136/hrt.79.2.128
Copyright © 1998 BMJ Publishing Group Ltd & British Cardiovascular Society

Heart 1998;79:128-132 ( February )

Efficacy of a new balloon catheter for internal cardioversion of chronic atrial fibrillation without anaesthesia

E Alt, R Ammer, G Lehmann, C Schmitt, J Pasquantonio, A Schömig

Department of Cardiology, Deutsches Herzzentrum München, Klinik an der Technischen Universität, and I. Med. Klinik, Klinikum rechts der Isar der Technischen Universität, München, Germany

Correspondence to: Dr Alt, I. Med. Klinik, Klinikum rechts der Isar, Ismaninger Strabeta e 22, D - 81675 München, Germany. email: alt{at}med1.med.tu-muenchen.de

Accepted for publication 22 July 1997

Objective---To compare a new internal cardioversion system incorporated into a balloon guided catheter with a conventional two electrode system in patients with atrial fibrillation (AF).
Design---Prospective study.
Patients---74 patients with chronic AF treated by internal cardioversion.
Materials---A 7.5 F balloon catheter with high energy electrode arrays each consisting of six 0.5 cm platinum rings. Brachial vein access enables one electrode array to be placed in the left pulmonary artery (distal pole) and the other at the lateral right atrial wall (proximal pole). The conventional two electrode system consists of 6 F electrodes placed in the proximal left pulmonary artery (anode) and the lower right atrium.
Interventions---Internal cardioversion was performed by shocks delivered in 40 V incremental steps from an external defibrillator. Shocks were applied by the new device to 32 patients (group A) and by the conventional sysytem to 42 patients (group B).
Results---The groups differed with respect to system positioning (9.2 (7.3) v 12.3 (8.1) minutes, p < 0.05) and fluoroscopy times (1.7 (1.0) v 3.3 (2.1) minutes, p < 0.01). Sinus rhythm was restored in 30 patients of group A and in 39 of group B (NS) with mean (SD) energy requirements of 8.4 (3.1) J and 7.2 (3.1) J, respectively (NS).
Conclusions---This new method of internal cardioversion has comparably high primary success rates and low sedation requirements with single and two lead systems.

Keywords: atrial fibrillation;  catheter;  defibrillation;  internal cardioversion

© 1998 by Heart
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This article has been cited by other articles:

  • Fan, K., Lee, K. L., Chow, W.-H., Chau, E., Lau, C.-P. (2002). Internal Cardioversion of Chronic Atrial Fibrillation During Percutaneous Mitral Commissurotomy: Insight Into Reversal of Chronic Stretch-Induced Atrial Remodeling. Circulation 105: 2746-2752 [Abstract] [Full Text]  
  • Lehmann, G., Horcher, J., Dennig, K., Plewan, A., Ulm, K., Alt, E. (2002). Atrial Mechanical Performance After Internal and External Cardioversion of Atrial Fibrillation : An Echocardiographic Study. Chest 121: 13-18 [Abstract] [Full Text]  
  • Ammer, R., Lehmann, G.u., Plewan, A., Puetter, K., Alt, E. (1999). Marked reduction in atrial defibrillation thresholds with repeated internal cardioversion. J Am Coll Cardiol 34: 1569-1576 [Abstract] [Full Text]  

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