Transoesophageal versus transchest DC cardioversion.

DJ Cochrane, D McEneaney, JMCC Anderson, AAJ Adgey

    Research output: Contribution to journalArticle

    5 Citations (Scopus)

    Abstract

    Attempted cardioversion via the oesophagus (transoesophageal cardioversion) was compared with the transchest approach (transchest cardioversion) in a randomized trial of 100 consecutive patients with atrial fibrillation. For the transoesophageal group, 30, 50 and 100 J were delivered via an oesophageal electrode with subsequent 200 and 360 J transchest if required. For the transchest group, 50, 100, 200 and 360 J were delivered if required. In the transoesophageal group, 36/50 (72%) of patients cardioverted using the transoesophageal route alone, and in the transchest group, 41/50 (82%) of patients cardioverted (p = NS). First shock success was similar for the transoesophageal and transchest groups: 13/50 (26%) vs. 8/50 (16%) respectively. The mean number of shocks required to achieve successful cardioversion was identical for the transoesophageal and transchest groups (2.6). However, transoesophageal cardioversion was more successful than transchest cardioversion at energies < or = 100 J (36/50 [72%], and 17/50 [34%], p < 0.05). Median total energy for successful cardioversion was lower for patients in the transoesophageal group (180 J) than the transchest group (350 J) and mean peak current at successful cardioversion was also lower for patients in the transoesophageal group (21.7 A) than the transchest group (27.3 A) (p < 0.05). No oesophageal complications occurred. Thus, using an oesophageal electrode, cardioversion can be achieved as successfully as using the transchest route. The transoesophageal approach offers a low impedance, and consequently a low-energy pathway for cardioversion.
    LanguageEnglish
    Pages507-511
    JournalThe Quarterly Journal of Medicine
    Volume86
    Issue number8
    Publication statusPublished - Aug 1993

    Fingerprint

    Electric Countershock
    Shock
    Electrodes
    Electric Impedance
    Atrial Fibrillation
    Esophagus

    Keywords

    • Female
    • Humans
    • Male
    • Middle Aged
    • Atrial Fibrillation/et [Etiology]
    • Atrial Fibrillation/th [Therapy]
    • Electric Countershock/mt [Methods]
    • Treatment Outcome

    Cite this

    Cochrane, DJ., McEneaney, D., Anderson, JMCC., & Adgey, AAJ. (1993). Transoesophageal versus transchest DC cardioversion. The Quarterly Journal of Medicine, 86(8), 507-511.
    Cochrane, DJ ; McEneaney, D ; Anderson, JMCC ; Adgey, AAJ. / Transoesophageal versus transchest DC cardioversion. In: The Quarterly Journal of Medicine. 1993 ; Vol. 86, No. 8. pp. 507-511.
    @article{17f01ca1e0c0452f8407f1a6c5b4f6d5,
    title = "Transoesophageal versus transchest DC cardioversion.",
    abstract = "Attempted cardioversion via the oesophagus (transoesophageal cardioversion) was compared with the transchest approach (transchest cardioversion) in a randomized trial of 100 consecutive patients with atrial fibrillation. For the transoesophageal group, 30, 50 and 100 J were delivered via an oesophageal electrode with subsequent 200 and 360 J transchest if required. For the transchest group, 50, 100, 200 and 360 J were delivered if required. In the transoesophageal group, 36/50 (72{\%}) of patients cardioverted using the transoesophageal route alone, and in the transchest group, 41/50 (82{\%}) of patients cardioverted (p = NS). First shock success was similar for the transoesophageal and transchest groups: 13/50 (26{\%}) vs. 8/50 (16{\%}) respectively. The mean number of shocks required to achieve successful cardioversion was identical for the transoesophageal and transchest groups (2.6). However, transoesophageal cardioversion was more successful than transchest cardioversion at energies < or = 100 J (36/50 [72{\%}], and 17/50 [34{\%}], p < 0.05). Median total energy for successful cardioversion was lower for patients in the transoesophageal group (180 J) than the transchest group (350 J) and mean peak current at successful cardioversion was also lower for patients in the transoesophageal group (21.7 A) than the transchest group (27.3 A) (p < 0.05). No oesophageal complications occurred. Thus, using an oesophageal electrode, cardioversion can be achieved as successfully as using the transchest route. The transoesophageal approach offers a low impedance, and consequently a low-energy pathway for cardioversion.",
    keywords = "Female, Humans, Male, Middle Aged, Atrial Fibrillation/et [Etiology], Atrial Fibrillation/th [Therapy], Electric Countershock/mt [Methods], Treatment Outcome",
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    year = "1993",
    month = "8",
    language = "English",
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    Cochrane, DJ, McEneaney, D, Anderson, JMCC & Adgey, AAJ 1993, 'Transoesophageal versus transchest DC cardioversion.', The Quarterly Journal of Medicine, vol. 86, no. 8, pp. 507-511.

    Transoesophageal versus transchest DC cardioversion. / Cochrane, DJ; McEneaney, D; Anderson, JMCC; Adgey, AAJ.

    In: The Quarterly Journal of Medicine, Vol. 86, No. 8, 08.1993, p. 507-511.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Transoesophageal versus transchest DC cardioversion.

    AU - Cochrane, DJ

    AU - McEneaney, D

    AU - Anderson, JMCC

    AU - Adgey, AAJ

    N1 - Cochrane Group Name: Cochrane Heart Group

    PY - 1993/8

    Y1 - 1993/8

    N2 - Attempted cardioversion via the oesophagus (transoesophageal cardioversion) was compared with the transchest approach (transchest cardioversion) in a randomized trial of 100 consecutive patients with atrial fibrillation. For the transoesophageal group, 30, 50 and 100 J were delivered via an oesophageal electrode with subsequent 200 and 360 J transchest if required. For the transchest group, 50, 100, 200 and 360 J were delivered if required. In the transoesophageal group, 36/50 (72%) of patients cardioverted using the transoesophageal route alone, and in the transchest group, 41/50 (82%) of patients cardioverted (p = NS). First shock success was similar for the transoesophageal and transchest groups: 13/50 (26%) vs. 8/50 (16%) respectively. The mean number of shocks required to achieve successful cardioversion was identical for the transoesophageal and transchest groups (2.6). However, transoesophageal cardioversion was more successful than transchest cardioversion at energies < or = 100 J (36/50 [72%], and 17/50 [34%], p < 0.05). Median total energy for successful cardioversion was lower for patients in the transoesophageal group (180 J) than the transchest group (350 J) and mean peak current at successful cardioversion was also lower for patients in the transoesophageal group (21.7 A) than the transchest group (27.3 A) (p < 0.05). No oesophageal complications occurred. Thus, using an oesophageal electrode, cardioversion can be achieved as successfully as using the transchest route. The transoesophageal approach offers a low impedance, and consequently a low-energy pathway for cardioversion.

    AB - Attempted cardioversion via the oesophagus (transoesophageal cardioversion) was compared with the transchest approach (transchest cardioversion) in a randomized trial of 100 consecutive patients with atrial fibrillation. For the transoesophageal group, 30, 50 and 100 J were delivered via an oesophageal electrode with subsequent 200 and 360 J transchest if required. For the transchest group, 50, 100, 200 and 360 J were delivered if required. In the transoesophageal group, 36/50 (72%) of patients cardioverted using the transoesophageal route alone, and in the transchest group, 41/50 (82%) of patients cardioverted (p = NS). First shock success was similar for the transoesophageal and transchest groups: 13/50 (26%) vs. 8/50 (16%) respectively. The mean number of shocks required to achieve successful cardioversion was identical for the transoesophageal and transchest groups (2.6). However, transoesophageal cardioversion was more successful than transchest cardioversion at energies < or = 100 J (36/50 [72%], and 17/50 [34%], p < 0.05). Median total energy for successful cardioversion was lower for patients in the transoesophageal group (180 J) than the transchest group (350 J) and mean peak current at successful cardioversion was also lower for patients in the transoesophageal group (21.7 A) than the transchest group (27.3 A) (p < 0.05). No oesophageal complications occurred. Thus, using an oesophageal electrode, cardioversion can be achieved as successfully as using the transchest route. The transoesophageal approach offers a low impedance, and consequently a low-energy pathway for cardioversion.

    KW - Female

    KW - Humans

    KW - Male

    KW - Middle Aged

    KW - Atrial Fibrillation/et [Etiology]

    KW - Atrial Fibrillation/th [Therapy]

    KW - Electric Countershock/mt [Methods]

    KW - Treatment Outcome

    M3 - Article

    VL - 86

    SP - 507

    EP - 511

    JO - Quarterly Journal of Medicine

    T2 - Quarterly Journal of Medicine

    JF - Quarterly Journal of Medicine

    SN - 0033-5622

    IS - 8

    ER -

    Cochrane DJ, McEneaney D, Anderson JMCC, Adgey AAJ. Transoesophageal versus transchest DC cardioversion. The Quarterly Journal of Medicine. 1993 Aug;86(8):507-511.