[The efficacy of scheduled cardioversion in atrial fibrillation. Comparison of two schemes of treatment: electrical versus pharmacological cardioversion].
OBJECTIVE
Atrial fibrillation is an arrhythmia with high morbidity and mortality. Restoring sinus rhythm is one of the principle objectives in its management. The present study aimed to assess the efficacy of scheduled cardioversion on atrial fibrillation by comparing two different therapeutic approaches: electrical vs. pharmacological cardioversion.


METHODS
Two hundred thirty patients with atrial fibrillation of more than 48 hours duration and requiring sinus rhythm restoration were included. One hundred forty-four patients underwent external electrical cardioversion and 86 patients received quinidine. We analyzed the rate of success, duration of hospital stay, complications and clinical and echocardiographic variable that might predict success.


RESULTS
Sinus rhythm was restored in 181 of 230 patients (79%). The rate of success was 77% (111/144 patients) in the electrical group and 81% (70 of 86 patients) in the pharmacological group (ns). In 13 pharmacological group patients for whom the first attempt failed attempt, a second attempt with electrical cardioversion was made and was successful in 8 patients (61%). No embolic complication was recorded and only two electrical disturbances were seen. Only atrial fibrillation lasting less than 8 weeks was associated with a higher success rate (p < 0.01).


CONCLUSIONS
Scheduled cardioversion in atrial fibrillation is an effective technique with a high success rate and a very low rate of complication. Electrical cardioversion and pharmacological cardioversion with quinidine are similarly effective, although the latter involves a longer hospital stay.
Valencia Martín
José
J
Servicio de Cardiología, Hospital General de Alicante, Spain. vcliment@coma.es
Climent Payá
Vicente E
VE
Marín Ortuño
Francisco
F
Monmeneu Menadas
José Vicente
JV
Martínez Martínez
Juan G
JG
García Martínez
Miguel
M
Ibáñez Criado
Alicia
A
García De Burgos Rico
Fernando
F
Sogorb Garri
Francisco
F
D001281:Atrial Fibrillation / Q000188:drug therapy / Q000628:therapy*; D004554:Electric Countershock / Q000379:methods*; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies