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Successful External Cardioversion via Fluoroscopic Electrode Positioning in Patients with Enlarged Trans-Thoracic Diameter
Journal article   Open access

Successful External Cardioversion via Fluoroscopic Electrode Positioning in Patients with Enlarged Trans-Thoracic Diameter

Koroush Khalighi, Amirsina Talebian, Rubinder Singh Toor and Seyed Abbas Mirabbasi
The American journal of case reports, v 19
15 Feb 2018
DOI: https://doi.org/10.12659/AJCR.907143
PMID: 29445077
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.12659/ajcr.907143View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open
url
https://doi.org/10.12659/AJCR.907143View
Published, Version of Record (VoR) Open

Abstract

Aged Atrial Fibrillation - diagnostic imaging Atrial Fibrillation - therapy Cardiac Catheterization - methods Defibrillators, Implantable Electric Countershock - methods Electrodes, Implanted Female Fluoroscopy - methods Follow-Up Studies Humans Male Middle Aged Obesity, Morbid - physiopathology Recurrence Retreatment Risk Assessment Sampling Studies Severity of Illness Index Treatment Failure Treatment Outcome
BACKGROUND Atrial fibrillation is the most common cardiac arrhythmia. It increases the risk of stroke by at least five-fold and is associated with higher risk for mortality and morbidity. Therefore, prompt diagnosis and treatment is crucial. In addition to anti-coagulation therapy, electrical and pharmacological cardioversion to restore sinus rhythm remains the standard of care. The most common and effective method for electrical cardioversion is achieved with placement of electrodes in the anteroposterior position. CASE REPORT We present three cases of patients with initial unsuccessful cardioversion attempts for persistent atrial fibrillation. These patients had elevated body mass indices and large trans-thoracic diameters. Their initial external cardioversion via the conventional method was not successful for restoration of sinus rhythm. This failure may have been attributed to their body habitus. To ensure that the current would traverse through the atrial tissue, the electrode pads were applied using fluoroscopic guidance for adequate myocardial depolarization. CONCLUSIONS Optimal fluoroscopic placement of the electrode pads during external cardioversion procedure increases the odds of successful restoration of sinus rhythm when compared to the conventional method.

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4 citations in Web of Science
5 citations in Scopus

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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