14th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 2000

Jan. 29 - Feb. 5, 2000
Marilleva, Trento, Italy

RT-168

Technical issues to reduce atrial defibrillation threshold in low energy internal atrial cardioversion

Giuseppe Boriani, Mauro Biffi, Francesco Pergolini, Claudia Camanini, Ivan Corazza, Pietro Bartolini*, Vincenzo Barbaro*, Romano Zannoli, Angelo Branzi.
Institute of Cardiology, University of Bologna, *Istituto Superiore di Sanita, Rome, Italy

Introduction

Internal cardioversion (CV) of atrial fibrillation (AF) is a highly effective procedure that can be performed by delivering biphasic shocks at relatively low energies (<6-10 joules) through transvenous catheters^1-6. This procedure can be effective even in patients with long standing chronic persistent AF and also in patients with previous ineffective transthoracic shocks⁷.

Internal CV can be performed without need for sedation or anesthetics in up to 60% of patients with chronic persistent AF⁵. In view of the clinical results obtained in this field^1-5, a great interest is actually devoted to ameliorate patients’ tolerance to shock induced discomfort. This interest is also motivated by the perspective of a widening of indications to implantable devices for treating AF by delivery of intracardiac shocks^8,9.