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Low-energy intracardiac shocks during atrial fibrillation: effects on cardiac rhythm

(1997) AMERICAN HEART JOURNAL. 133(1). p.101-107
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Abstract
The effect on ventricular rate of intracardiac shocks for atrial fibrillation was studied in 13 patients receiving 95 shocks. Shocks were synchronized to the R wave and were delivered after R-R intervals >500 msec, with increasing strength (20 to 400 V). In 10 patients, conversion to sinus rhythm was achieved in this way. Noneffective shocks increased the mean first postshock R-R interval (compared with 20 V as baseline), for shocks greater than or equal to 140 V. The R-R prolongation correlated with the shock level (r = 0.936, p < 0.01). Subsequent R-R intervals were comparable to baseline. A similar trend toward longer first postshock intervals was observed for effective shocks. However, the maximal first R-R interval after noneffective shocks had no relation to the voltage. The number of pauses >1500 msec tended to increase with voltage (noneffective shocks). Pauses >2500 msec were exceptional (4 of 85 noneffective shocks). No symptomatic bradycardia occurred. In subsequent intervals (cycles 2 through 10) no pauses >2500 msec were noted. It is concluded that atrial defibrillation attempts between the right atrium and coronary sinus prolong R-R intervals, in relation to administered energy, but without the need for backup pacing.
Keywords
DEFIBRILLATION, CARDIOVERSION, TACHYARRHYTHMIAS, FIELDS, SHEEP

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Citation

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Chicago
Gjorgov, Nikola, Frank Provenier, and Luc Jordaens. 1997. “Low-energy Intracardiac Shocks During Atrial Fibrillation: Effects on Cardiac Rhythm.” American Heart Journal 133 (1): 101–107.
APA
Gjorgov, N., Provenier, F., & Jordaens, L. (1997). Low-energy intracardiac shocks during atrial fibrillation: effects on cardiac rhythm. AMERICAN HEART JOURNAL, 133(1), 101–107.
Vancouver
1.
Gjorgov N, Provenier F, Jordaens L. Low-energy intracardiac shocks during atrial fibrillation: effects on cardiac rhythm. AMERICAN HEART JOURNAL. 1997;133(1):101–7.
MLA
Gjorgov, Nikola, Frank Provenier, and Luc Jordaens. “Low-energy Intracardiac Shocks During Atrial Fibrillation: Effects on Cardiac Rhythm.” AMERICAN HEART JOURNAL 133.1 (1997): 101–107. Print.
@article{181604,
  abstract     = {The effect on ventricular rate of intracardiac shocks for atrial fibrillation was studied in 13 patients receiving 95 shocks. Shocks were synchronized to the R wave and were delivered after R-R intervals {\textrangle}500 msec, with increasing strength (20 to 400 V). In 10 patients, conversion to sinus rhythm was achieved in this way. Noneffective shocks increased the mean first postshock R-R interval (compared with 20 V as baseline), for shocks greater than or equal to 140 V. The R-R prolongation correlated with the shock level (r = 0.936, p {\textlangle} 0.01). Subsequent R-R intervals were comparable to baseline. A similar trend toward longer first postshock intervals was observed for effective shocks. However, the maximal first R-R interval after noneffective shocks had no relation to the voltage. The number of pauses {\textrangle}1500 msec tended to increase with voltage (noneffective shocks). Pauses {\textrangle}2500 msec were exceptional (4 of 85 noneffective shocks). No symptomatic bradycardia occurred. In subsequent intervals (cycles 2 through 10) no pauses {\textrangle}2500 msec were noted. It is concluded that atrial defibrillation attempts between the right atrium and coronary sinus prolong R-R intervals, in relation to administered energy, but without the need for backup pacing.},
  author       = {Gjorgov, Nikola and Provenier, Frank and Jordaens, Luc},
  issn         = {0002-8703},
  journal      = {AMERICAN HEART JOURNAL},
  keyword      = {DEFIBRILLATION,CARDIOVERSION,TACHYARRHYTHMIAS,FIELDS,SHEEP},
  language     = {eng},
  number       = {1},
  pages        = {101--107},
  title        = {Low-energy intracardiac shocks during atrial fibrillation: effects on cardiac rhythm},
  url          = {http://dx.doi.org/10.1016/S0002-8703(97)70254-0},
  volume       = {133},
  year         = {1997},
}

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