Internal cardioversion in two patients with atrial fibrillation refractory to external cardioversion.
A 26-year-old man underwent an electrophysiological study for evaluation of a history of congenital heart disease, presyncope, and wide complex tachycardia. During the study the patient developed sustained atrial fibrillation with a rapid ventricular response. A 17-year-old man with a history of sick sinus syndrome developed sustained atrial fibrillation. Both patients failed four attempts at external cardioversion with a maximum delivered energy of 360 J. Low energy cardioversion was successful in both patients using biphasic waveforms and internal transvenous defibrillation electrodes. Internal cardioversion using a transvenous electrode system can be successful in patients with atrial fibrillation refractory to external cardioversion.
Cooper
R A
RA
Department of Cardiology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Johnson
E E
EE
Kanter
R J
RJ
Merrill
J J
JJ
Sorentino
R A
RA
Wharton
J M
JM
D000293:Adolescent; D000328:Adult; D001281:Atrial Fibrillation / Q000628:therapy*; D017147:Defibrillators, Implantable; D004554:Electric Countershock; D004567:Electrodes, Implanted; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D008297:Male; D012804:Sick Sinus Syndrome / Q000150:complications; D013575:Syncope / Q000150:complications; D013610:Tachycardia / Q000150:complications