Publication details
Identifying Parameters Associated with the Use of Higher Discharge Energy in Electrical Cardio version for Persistent Atrial Fibrillation
| Authors | |
|---|---|
| Year of publication | 2023 |
| Type | Article in Periodical |
| Magazine / Source | Journal of Atrial Fibrillation & Electrophysiology |
| MU Faculty or unit | |
| Citation | |
| Web | https://jafib-ep.com/journal/volume-16-issue-2-jan-2023/original-research-identifying-parameters-associated-with-the-use-of-higher-discharge-energy-in-electrical-cardio-version-for-persistent-atrial-fibrillation/ |
| Keywords | Amiodarone; Atrial Fibrillation; Electrical Cardioversion |
| Description | Background: Direct current cardioversion (DCCV) is a safe and effective method of terminating persistent atrial fibrillation (AF) and recovering sinus rhythm (SR) rapidly. Aims: This study aimed to identify the effectiveness of DCCV in patients with persistent AF and the descriptors that drive cardiologists to use higher discharge energy. In addition, whether these parameters are associated with greater DCCV efficacy was also assessed. Methods: After a retrospective analysis of all consecutive DCCVs performed for persistent AF, we performed a multivariate analysis of factors associated with the choice of higher energy DCCV and the efficacy of DCCV in acutely achieving sinus rhythm. Results: A total of 1853 DCCVs were performed in 1264 patients during the study period with a diagnosis of persistent AF. Applying one to three DCCV discharges in one series achieved SR in 89.6% of procedures. The mean energy of the DCCV was 119.0 J. The multivariate analysis then looked for parameters used by cardiologists to select DCCV energy higher than the median DCCV energy in our cohort. As a result, patient weight (P<0.0001) and amiodarone use (P=0.0069) were significantly associated with the choice of higher energy. However, in multivariate analysis, none of the examined parameters emerged as a potential predictor of success. Conclusions: DCCV remains an effective method for the acute attainment of SR. In addition, cardiologists in this cohort subconsciously considered patient weight and amiodarone use as parameters for selecting higher energy for the first shock during DCCV. However, the multivariate analysis of patient outcomes did not support this practice for persistent AF. |