title: Clinical feasibility of low energy internal atrial cardioversion with a three-electrode configuration in patients with unsuccessful conventional configurations.
abstract: Low energy internal cardioversion is a safe and highly effective method for atrial fibrillation termination. We will describe 6 patients in whom the conventional 2-electrode systems with the defibrillation leads positioned in the right atrium and in the coronary sinus or left pulmonary artery failed to terminate the arrhythmia despite the use of maximal available energies. A 3-electrode configuration including right atrium, coronary sinus and left pulmonary artery was used in order to encompass as much atrial mass as possible between the cathode and the anode. The atrial fibrillation was successfully interrupted in 4 out of 6 patients. The creation of a 3-electrode configuration may be a further technical expedient in order to increase the success rate of internal cardioversion when usual manoeuvres like lead repositioning, reversion of polarity, or addition of antiarrhythmic drugs are ineffective.
authors.affiliation: Sezione di Aritmologia, Casa di Cura S. Anna, Brescia.
authors.forename: G
authors.initials: G
authors.lastname: Benedini
authors.forename: A
authors.initials: A
authors.lastname: Gardini
authors.forename: T
authors.initials: T
authors.lastname: Toselli
authors.forename: G
authors.initials: G
authors.lastname: Antonioli
authors.forename: G
authors.initials: G
authors.lastname: Guardigli
authors.forename: G
authors.initials: G
authors.lastname: Saccomanno
authors.forename: M
authors.initials: M
authors.lastname: Marini
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000628:therapy*; D004554:Electric Countershock / Q000379:methods*; D004566:Electrodes; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged