title: Efficacy of biphasic waveform compared to monophasic waveform for cardioversion of atrial flutter in pediatric patients.
abstract: The efficacy of biphasic waveform cardioversion of atrial flutter in pediatric patients has not previously been demonstrated. Cardioversion outcomes were compared in two sequential groups of patients with atrial flutter undergoing transthoracic cardioversion using monophasic and biphasic waveforms at a single pediatric institution. The mean energy required for procedural success was 1.7 +/- 1.2 J/kg in the monophasic group compared to 0.9 +/- 0.6 J/kg in the biphasic group (p = 0.002). The mean number of attempts before achieving procedural success was 1.9 +/- 1.2 for the monophasic group and 1.3 +/- 1.0 for the biphasic group (p = 0.019). Procedure success rate was 89.5% (33/38) in the monophasic group compared to 100% (27/27) in the biphasic group (p = 0.13). Success rate for biphasic waveform cardioversion was 83% (5/6) when using energy less than 0.5 J/kg. These findings provide the impetus for lower starting energies and more widespread use of devices utilizing biphasic waveforms in pediatric patients.
authors.affiliation: Division of Cardiology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA. abatra@iupui.edu
authors.forename: A S
authors.initials: AS
authors.lastname: Batra
authors.forename: B S
authors.initials: BS
authors.lastname: Hasan
authors.forename: R A
authors.initials: RA
authors.lastname: Hurwitz
mesh_terms: D000367:Age Factors; D001282:Atrial Flutter / Q000628:therapy*; D002648:Child; D004554:Electric Countershock / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome