title: Evaluating the Efficacy and Safety of Internal Cardioversion with Implantable Cardioverter Defibrillator Device for Atrial Fibrillation in Systolic Heart Failure Patients.
abstract: BACKGROUND
  Atrial fibrillation (AF) commonly observed in patients with heart failure and cardioversion was often needed to restore the sinus rhythm. Previously, there is no study evaluating usefulness of internal cardioversion with implantable cardioverter defibrillator (ICD) device. In this study, we aimed to compare the efficacy and long-term effects of internal cardioversion with ICD devices compared to conventional external cardioversion in patients with AF and heart failure.
  
  
  METHODS
  Seventy patients with AF and heart failure who underwent electrical cardioversion were enrolled in the study. Forty patients (mean age 65.36 ± 10.37, 35 male) were assigned to undergo internal cardioversion with approximately 35 J shocks delivered through the ICD electrode. Standard external cardioversion was performed for the remaining patients (30 patients; mean age 66.20 ± 11.89; 24 male) that were similar with regard to baseline, and electrocardiographic characteristics.
  
  
  RESULTS
  Sinus rhythm was restored in 32 of 40 patients (80.0%) assigned to internal cardioversion compared with 25 of 30 patients (83.3%) assigned to external cardioversion (P = 0.725). We did not witness any serious complication during the procedure and hospitalization. On the follow-up, there was no statistically significant difference in recurrence of AF and incidence of major cardiovascular events between the internal and external cardioversion groups.
  
  
  CONCLUSIONS
  Internal cardioversion with ICD device is an effective and safe method to restore sinus rhythm in heart failure patients with AF.
authors.affiliation: Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey.
authors.forename: Hamza
authors.initials: H
authors.lastname: Sunman
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhıye, Ankara, Turkey.
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhıye, Ankara, Turkey.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Yorgun
authors.affiliation: Department of Cardiology, Türkiye Yüksek İhtisas Hospital, Ankara, Turkey.
authors.forename: Uğur
authors.initials: U
authors.lastname: Canpolat
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhıye, Ankara, Turkey.
authors.forename: Muhammet Ulvi
authors.initials: MU
authors.lastname: Yalçin
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhıye, Ankara, Turkey.
authors.forename: Naresh
authors.initials: N
authors.lastname: Maharjan
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhıye, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Asil
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhıye, Ankara, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Şahiner
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhıye, Ankara, Turkey.
authors.forename: Barış
authors.initials: B
authors.lastname: Kaya
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhıye, Ankara, Turkey.
authors.forename: Necla
authors.initials: N
authors.lastname: Özer
authors.affiliation: Department of Cardiology, Hacettepe University Faculty of Medicine, Sıhhıye, Ankara, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000628:therapy*; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D054143:Heart Failure, Systolic / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
keywords: atrial fibrillation; heart failure; internal cardioversion