From the Department of Cardiothoracic Surgery, University of Regensburg,
Regensburg, Germany.
Correspondence to Dr Andreas Liebold, Klinik für Herz-, Thorax-, und herznahe Gefäßchirurgie, Klinikum der Universität Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany. E-mail andreas.liebold{at}klinik.uni-regensburg.de
Background—Atrial fibrillation (AF)
is the most common arrhythmia after open heart surgery.
Traditional treatment with a range of antiarrhythmic drugs and
electrical cardioversion is associated with considerable side effects.
The aim of this study was to examine the feasibility and efficacy of
low-energy atrial defibrillation with temporary epicardial
defibrillation wire electrodes.
Methods and Results—Epicardial defibrillation wire
electrodes were placed at the left and right atria during open heart
surgery in 100 consecutive patients (age 65±9 years; male to female
ratio 67:23). Electrophysiological studies
performed postoperatively revealed a test shock (0.3 J) impedance of
96±12
Conclusions—Atrial defibrillation with temporary epicardial wire
electrodes can be performed safely and effectively in patients after
cardiac operations. The shock energy required to restore sinus rhythm
is low. Thus, patients can be cardioverted without
anesthesia.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Low-Energy Cardioversion With Epicardial Wire Electrodes: New Treatment of Atrial Fibrillation After Open Heart Surgery
(monophasic) and 97±13 (biphasic). During their
hospital stay, AF occurred in 23 patients (23%) at 2.1±1.3 days
postoperatively. Internal atrial defibrillation was performed in 20
patients. Of these patients, 80% (16/20) were successfully
cardioverted with a mean energy of 5.2±3 J. Early recurrence
of AF (
60 seconds after defibrillation) developed in 8 patients. Five
patients had multiple episodes of AF. In total, 35 episodes of AF were
treated, with an 88% success rate. Only 6 patients (30%)
required sedation. No complications were observed with shock
application or with lead extraction.
Key Words: defibrillation • electrical stimulation • atrium • cardioversion
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