title: Improvement of cerebral oxygen saturation after successful electrical cardioversion of atrial fibrillation.
abstract: OBJECTIVE
  Cerebral and microvascular perfusion is reduced in atrial fibrillation (AF). Maintenance of brain perfusion is important in acute disease and long-term course. Assessment of brain perfusion and oxygenation is difficult in clinical practice. Our study aimed to determine changes in cerebral tissue oxygen saturation (SctO2) with bedside near-infrared spectroscopy (NIRS).
  
  
  RESULTS
  Twenty patients (mean age 67.7 ± 10.2 years, 50% men) in whom electrical cardioversion (CV) was successful were prospectively studied. Ten patients (mean age 64.2 ± 7.7 years, 80% men) in whom CV was not successful served as control group. Bilateral SctO2, mean arterial pressure (MAP), arterial oxygen saturation (SaO2), and heart rate were recorded and changes of all parameters before and after CV were compared between the groups. Our results show an increase in SctO2 after successful CV that was significantly higher compared with patients who remained in AF (right SctO2 3.25 ± 2.5 vs. -0.13 ± 0.52%, P = 0.001; left SctO2 4.27 ± 3.56 vs. -0.38 ± 2.4%, P < 0.001). Neither arterial blood pressure nor SaO2 changes differed significantly between the two groups. No correlation could be detected between the significant increase of SctO2 after successful CV and arterial blood pressure, SaO2, or heart rate.
  
  
  CONCLUSIONS
  Cerebral tissue oxygen saturation increases significantly after restoration of sinus rhythm. Near-infrared spectroscopy monitoring can identify changes of SctO2 after successful CV of AF independent from standard monitoring parameters (MAP, SaO2). Near-infrared spectroscopy can be used to detect cerebral oxygen saturation deficits in AF patients or patients at high risk for AF. Clinical applications may include monitoring during ablation procedures and in critical care.
authors.affiliation: Department of Cardiology, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Wutzler
authors.forename: Jens
authors.initials: J
authors.lastname: Nee
authors.forename: Leif-Hendrik
authors.initials: LH
authors.lastname: Boldt
authors.forename: York
authors.initials: Y
authors.lastname: Kühnle
authors.forename: Saskia
authors.initials: S
authors.lastname: Gräser
authors.forename: Tim
authors.initials: T
authors.lastname: Schröder
authors.forename: Wilhelm
authors.initials: W
authors.lastname: Haverkamp
authors.forename: Christian
authors.initials: C
authors.lastname: Storm
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D062186:Arterial Pressure; D001281:Atrial Fibrillation / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation; D004554:Electric Countershock; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D010100:Oxygen
keywords: Atrial fibrillation; Cardioversion; Cerebral oxygen saturation; Monitoring; Near-infrared spectroscopy