RT-189
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Influence of antiarrhythmic
therapy on atrial defibrillation threshold in patients with persistent atrial fibrillation
submitted to an external electrical cardioversion
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Alessandro Capucci, Giovanni
Quinto Villani, Daniela Aschieri, Alessandro Rosi.
Divisione di Cardiologia, Ospedale Civile, Piacenza, Italy
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Abstract
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Antiarrhythmic drugs have been generally found to
negatively interfere with the ventricular defibrillation threshold.
Few data are already available on the effects of medical therapy on atrial
defibrillation energy requirements.
From a review data and personal experience it came out how as far as external
defibrillation is common either class I or class III antiarrhythmic drugs do not
positively interfere with the atrial defibrillation threshold. Very recent data on
internal atrial defibrillation however found out a lower edge emergency requirement after
flecainide infusion either in chronic or induced atrial fibrillation.
This apparent discrepancy could be dependent on the objective difficulty to evaluate
threshold by the external defibrillation approach together with the electrophysiologic
effect of the IC drug that by prolonging the pattern of atrial activation increases the
gap of excitability thus lowering the defibrillation threshold.
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Key Words
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Atrial fibrillation – transvenous internal
cardioversion
AF defibrillation threshold, external cardioversion, antiarrhythmic therapy influence,
class I, Ic, III drugs, propafenone, amiodarone, d-sotalol, flecainide, R
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