How Effective and Safe Is Internal Direct Current Shock for Atrial Fibrillation Refractory to External Cardioversion?

  • M. Santini
  • C. Pandozi
  • S. Toscano
  • G. Altamura
  • A. Castro
  • S. Tonioni
  • B. Magris
Conference paper


In a group of patients (6%–50% in different series) with atrial fibrillation (AF) external cardioversion and pharmacological therapy failed to restore sinus rhythm. AF is not a benign arrhythmia; it causes disabling symptoms and hemodynamic disturbances related to the rapid ventricular response and/or to the loss of the atrial kick. Moreover, patients with AF are at a higher risk of systemic embolism and stroke as assessed by the Framingham study (1, 2). In patients with AF resistant to pharmacologie and transthoracic electrical cardioversion the following therapeutic options are available:
  • Drugs acting on the atrioventricular (AV) node conduction (verapamil, beta-blocking agents)

  • AV node or His bundle ablation with subsequent pacemaker insertion

  • High energy internal cardioversion (HEIC)

  • Low energy internal cardioversion (LEIC)


Atrial Fibrillation Sinus Rhythm Atrial Fibrillation Recurrence Chronic Atrial Fibrillation Atrial Size 
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.


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Copyright information

© Springer-Verlag Italia, Milano 1996

Authors and Affiliations

  • M. Santini
    • 1
  • C. Pandozi
    • 1
  • S. Toscano
    • 1
  • G. Altamura
    • 1
  • A. Castro
    • 1
  • S. Tonioni
    • 1
  • B. Magris
    • 1
  1. 1.Dipartimento delle Malattie del CuoreOspedale S Filippo NeriRomeItaly

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