Cardioversion of atrial fibrillation and subsequent maintenance of sinus rhythm
| Autor: | Hjgm Crijns, van Isabelle Gelder |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
atrial defibrillator
medicine.medical_specialty ACUTE CONVERSION Defibrillation QUINIDINE THERAPY medicine.medical_treatment Sedation Electric Countershock heart failure Cardioversion INTERNAL CARDIOVERSION cardioversion Heart Rate Recurrence Internal medicine Heart rate Atrial Fibrillation medicine FLECAINIDE ACETATE FLUTTER Humans Sinus rhythm business.industry Atrial fibrillation General Medicine medicine.disease EFFICACY LOW-ENERGY CARDIOVERSION electrical remodeling Defibrillators Implantable Tolerability TIME-COURSE Anesthesia Heart failure Cardiology ELECTRICAL CARDIOVERSION medicine.symptom Cardiology and Cardiovascular Medicine business ANTIARRHYTHMIC DRUGS |
| Zdroj: | Pace-Pacing and Clinical Electrophysiology, 20(10), 2675-2683. Wiley |
| ISSN: | 0147-8389 |
| Popis: | This article gives an overview of electrical cardioversion of AF and includes the discussion of newer strategies. DC external cardioversion is highly effective and carries a low risk of complications. Other approaches, like transesophageal cardioversion and high energy internal cardioversion, may improve the acute success rate but do not enhance long-term maintenance of sinus rhythm compared to external cardioversion. An atrial defibrillator may have important advantages which relate to the fact that the duration and possibly also the number of AF episodes become reduced. Supposedly, shortening the attacks of AF may exert an antiarrhythmic effect by limiting electrical, anatomical, and neurohumoral remodeling. So far, low energy biatrial defibrillation using an atrial defibrillator seems to be effective and safe (i.e., does not induce ventricular arrhythmias). However, discomfort limits its tolerability in clinical practice. Future improvement of leads and light sedation that is easy to administer may overcame this problem. In the second part of this overview, the probability of AF recurrence using a serial cardioversion approach is discussed. In middle-aged patients with a fair exercise tolerance and an arrhythmia duration |
| Databáze: | OpenAIRE |
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