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. 1998 Feb;79(2):128–132. doi: 10.1136/hrt.79.2.128

Efficacy of a new balloon catheter for internal cardioversion of chronic atrial fibrillation without anaesthesia

E Alt 1, R Ammer 1, G Lehmann 1, C Schmitt 1, J Pasquantonio 1, A Schomig 1
PMCID: PMC1728613  PMID: 9538303

Abstract

Objective—To compare a new internal cardioversion system incorporated into a balloon guided catheter with a conventional two electrode system in patients with atrial fibrillation (AF).
Design—Prospective study.
Patients—74 patients with chronic AF treated by internal cardioversion.
Materials—A 7.5 F balloon catheter with high energy electrode arrays each consisting of six 0.5 cm platinum rings. Brachial vein access enables one electrode array to be placed in the left pulmonary artery (distal pole) and the other at the lateral right atrial wall (proximal pole). The conventional two electrode system consists of 6 F electrodes placed in the proximal left pulmonary artery (anode) and the lower right atrium.
Interventions—Internal cardioversion was performed by shocks delivered in 40 V incremental steps from an external defibrillator. Shocks were applied by the new device to 32 patients (group A) and by the conventional sysytem to 42 patients (group B).
Results—The groups differed with respect to system positioning (9.2 (7.3) v 12.3 (8.1) minutes, p < 0.05) and fluoroscopy times (1.7 (1.0) v 3.3 (2.1) minutes, p < 0.01). Sinus rhythm was restored in 30 patients of group A and in 39 of group B (NS) with mean (SD) energy requirements of 8.4 (3.1) J and 7.2 (3.1) J, respectively (NS).
Conclusions—This new method of internal cardioversion has comparably high primary success rates and low sedation requirements with single and two lead systems.

 Keywords: atrial fibrillation;  catheter;  defibrillation;  internal cardioversion

Full Text

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Figure 1  .

Figure 1  

Figure 1  

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Custom built, single lead Swan-Ganz cardioversion catheter system. The middle of the atrial rings is individually connected for sensing and pacing, while others are connected in parallel (atrial array). One pole in the ventricle serves for ventricular sensing and stimulation, and the pulmonary rings are connected in parallel for atrial defibrillation (pulmonary array). Figure 2   Conventional two part catheter system for internal cardioversion of atrial fibrillation. The electrode on the left has individually connected rings suitable for sensing and stimulation of the atrium through one pole, while the others are used for shock application. All poles are in parallel in the electrode on the right.

Figure 3  .

Figure 3  

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Frontal (top) and left anterior oblique (bottom) chest radiographs of the new balloon catheter device in situ by means of brachial vein access ready for internal cardioversion of atrial fibrillation.

Figure 4  .

Figure 4  

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Frontal (top) and left anterior oblique (bottom) chest radiographs of the conventional two part system in situ. One electrode is positioned in the lower right atrium and the second in the left pulmonary artery by means of femoral vein access.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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