Antiarrhythmic Drug Therapy Before Electrical Cardioversion of Atrial Fibrillation: Is It Really Useful?

  • A. Capucci
  • F. F. Tarantino
  • G. Q. Villani
  • M. F. Piepoli
  • D. Aschieri
  • A. Rosi
Conference paper


Electrical cardioversion is actually the more effective way to convert persistent atrial fibrillation to sinus rhythm. The success rate of electric cardioversion is 75%–93% [1, 2]. The efficacy of the procedure mainly depends on atrial fibrillation duration and left atrial size. The success rate is about 90% in patients with atrial fibrillation duration of less than 1 year and 50% in patients with atrial fibrillation of 5 years duration [3]. Also patients with left atrial enlargement have less probability of returning to sinus rhythm or of maintaining sinus rhythm after successful cardioversion.


Atrial Fibrillation Sinus Rhythm Persistent Atrial Fibrillation Chronic Atrial Fibrillation Antiarrhythmic Drug Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Lown B (1967) Electrical reversion of arrhythmias. Br Heart J 29:469–489PubMedCrossRefGoogle Scholar
  2. 2.
    ResnekowL, Mc Donald L (1971) Electroconversion of lone atrial fibrillation andflutter, including hemodynamic studies at rest and on exercise. Br Heart J33:339–350CrossRefGoogle Scholar
  3. 3.
    ResnekovL (1980) Direct current shock. In: Chung EK (ed) Cardiac emergency care. (2ndedn) Lea & Febiger, Philadelphia pp 189–214Google Scholar
  4. 4.
    Rossi M, Lown B (1967) The use of quinidinein cardioversion. Am J Cardiol 19:234–238PubMedCrossRefGoogle Scholar
  5. 5.
    Van Gelder IC, Crijns HJ, Van Gilst WH R, Lie KI (1991) Prediction ofuneventful cardioversionand maintenance of sinus rhythm from direct-current electrical cardioversion ofchronic atrial fibrillation or flutter. Am J Cardiol 68:41–46PubMedCrossRefGoogle Scholar
  6. 6.
    DaytschaeverM, Haerynck F, Tavernier R, Jordaens L (1998) Factors influencing long-termpersistence of sinus rhythm after first electrical cardioversion for atrialfibrillation. PACE 21:284–287CrossRefGoogle Scholar
  7. 7.
    Wijffels MCEF, Kirchof CJHJ, Dorland R, Allessie MA(1995) Atrial fibrillation begets atrial fibrillation: a study in awakechronically instrumented goats. Circulation 92:1954–1968PubMedCrossRefGoogle Scholar
  8. 8.
    Tielman RG, Van Gelder IC, Crijns HJ, Kam PJ de, Van de Berg MP, Haaksma J, Van der Woude HJ,Allessie MA (1998) Early recurrences of atrial fibrillation after electricalcardioversion: a result of fibrillation induced electrical remodeling of theatria? J Am Coll Cardiol 31:167–173CrossRefGoogle Scholar
  9. 9.
    Crijns HJ, Van Gelder IC, Van Gilst WH, Hillege H, Gosselink AM, Lie KL (1991) Serial antiarrhythmic drug treatment to maintain sinusrhythm after electrical cardioversion for chronic atrial fibrillation or atrialflutter. Am J Cardiol 68:335–341PubMedCrossRefGoogle Scholar
  10. 10.
    CapucciA, Aschieri D,Villani GQ, Passerini F, Groppi F, Rosi A, Arruzzoli S (1997)Oral amiodarone increases efficacy of DC cardioversion in patients with chronicatrial fibrillation and organic heart disease. J Am Coll Cardiol 29[2 SupplA]:443AGoogle Scholar
  11. 11.
    Gosselink AT, Crijns HJ, Van Gelder IC, Hillige H, Wiesfeld AC, Lie KI (1992) Low dose amiodarone for maintenance of sinusrhythm after cardioversion of atrial fibrillation or flutter. JAMA267:3332–3333CrossRefGoogle Scholar
  12. 12.
    Bianconi L, Mennuni M, Lukic V, Castro A, Chieffi M,Santini M (1996) Effects of oral propafenone administration beforeelectrical cardioversion of chronic atrial fibrillation: a placebo controlledstudy. J Am Coll Cardiol 28:700–706PubMedCrossRefGoogle Scholar
  13. 13.
    Van Gelder IC, Crijns HJ, Van Gilst WH, De Lagen CD, Van Mijk LM, Lie KI (1989) Effects of flecainide on the atrial defibrillationthreshold. AmJCardiol 63:112–116CrossRefGoogle Scholar
  14. 14.
    BorianiG, Biffi M, Capucci A, Bronzetti G, Sabbatani P, Frabetti L, Zannoli R, BranziA, Magnani B (1996) Fibrillazione atriale: efficacia, sicurezza etollerabilità della car-dioversione elettrica endocavitaria a bassa energia.Cardiologia 41[Suppl 5]:47 (abstr)Google Scholar
  15. 15.
    Lok NS, Lau CP, Way TY, Wah HS (1995) Effect of Sotalol on transvenous atrial defibrillation for acute and chronic atrialfibrillation. J Am Coll Cardiol 25:109 A (abstr)Google Scholar
  16. 16.
    Santini M, Pandozi C, Toscano S, Castro A, Altamura G,Jesi AP, Gentilucci G, Villani M (1996) Intracardiac cardioversion of chronicatrial fibrillation. Cardiostimolazione 14:167 (abstr)Google Scholar
  17. 17.
    Boriani G, Biffi M, Capucci A, Sabbatani P, Bronzetti G,Frabetti L, Ayers GM, Magnani B (1997) Favourable effects of flecainide intransvenous low energy internal atrial cardioversion. PACE 20:1440 (abstr)Google Scholar

Copyright information

© Springer-Verlag Italia 2000

Authors and Affiliations

  • A. Capucci
    • 1
  • F. F. Tarantino
    • 1
  • G. Q. Villani
    • 1
  • M. F. Piepoli
    • 1
  • D. Aschieri
    • 1
  • A. Rosi
    • 1
  1. 1.Divisione di CardiologiaOspedale CivilePiacenzaItaly

Personalised recommendations