Internal cardioversion shortens periods of postoperative atrial fibrillation: results of a prospective, multicenter trial.
OBJECTIVE
Atrial fibrillation (AF) commonly occurs following open heart surgery especially in the high-risk group of old patients with reduced left ventricular function. Via Syncrus heart wires implanted on the left and right atrium internal cardioversion shocks can be applied. This prospective nonrandomized multicenter study compares duration of AF periods and clinical outcome in patients treated with Syncrus wires to a control group treated conventionally.


METHODS
In 88 patients Syncrus heart wires were implanted. Upon detection of AF antiarrhythmic medication was started for at least 6 hours followed by internal cardioversion. The results of this treatment were compared to a control group of 86 patients with an identical risk profile.


RESULTS
In the Syncrus group 53.4% of patients suffered from postoperative AF compared with 50.0% in the control group. Internal cardioversion led to restoration of sinus rhythm in 60% of patients at the first series of shocks (mean energy 7.7 +/- 1.3 J) and 95.8% with the second series (mean energy 8.6 +/- 0.5 J). Length of AF periods was 12.4 +/- 7.2 hours in the Syncrus group versus 42.9 +/- 19.6 hours in control patients.


CONCLUSIONS
Internal cardioversion using Syncrus heart wires demonstrated effectiveness in treating postoperative AF. Especially, length of AF periods could be diminished by the system with the expectation of reduction in hospital length of stay.
Dzemali
Omer
O
Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany.
Boehm
Dieter H
DH
Prehl
Jörg
J
Westphal
Bernd
B
Rbah
Belal
B
Kleine
Peter
P
D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D002304:Cardiac Pacing, Artificial; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents