Waveform optimisation for internal cardioversion of atrial fibrillation

V Kodoth, NC Castro, BM Glover, JMCC Anderson, OJ Escalona, E Lau, G Manoharan

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Introduction: A novel atrial defibrillator was developed at the Royal Victoria Hospital in collaboration with the Nanotechnology and Integrated Bio-Engineering Centre (NIBEC), University of Ulster. This device is powered by an external pulse of radiofrequency (RF) energy and designed to cardiovert using low tilt monophasic (LTMW) and low tilt biphasic waveform (LTBW), 12 ms pulse width. This study compared the safety and efficacy of LTMW with LTBW for transvenous cardioversion of atrial fibrillation (AF).Methods: Patients with persistent AF and with previous history of failed external cardioversion were randomised to LTMW or LTBW. Warfarin INR level was maintained in between 2-3 for 4 weeks prior cardioversion. St Jude’s defibrillating catheter was positioned in the distal coronary sinus and right atrium and connected to the defibrillator via a junction box. After a test shock using a dummy load, patient was cardioverted in a step up progression from 50V to 300V. Shock success was defined as return of sinus rhythm for >/=30 seconds. If cardioversion was unsuccessful at peak voltage patient was crossed over to the other arm of waveform type and cardioverted at peak voltage. Results: Thirty patients (50%) were equally randomised to LTBW and LTMW. Seven out of 15 (46%) cardioverted to sinus rhythm with LTBW and 1/15 (6%) with LTMW (p
LanguageEnglish
Pages689-693
JournalJournal of Electrocardiology
Volume44
Issue number6
Publication statusPublished - 2011

Fingerprint

Electric Countershock
Atrial Fibrillation
Defibrillators
Shock
Bioengineering
Nanotechnology
International Normalized Ratio
Coronary Sinus
Victoria
Warfarin
Heart Atria
Pulse
Catheters
Safety
Equipment and Supplies

Keywords

  • Atrial Fibrillation
  • Cardioversion
  • Defibrillator
  • ECG
  • Biphasic Waveform
  • Cardiology

Cite this

Kodoth, V., Castro, NC., Glover, BM., Anderson, JMCC., Escalona, OJ., Lau, E., & Manoharan, G. (2011). Waveform optimisation for internal cardioversion of atrial fibrillation. Journal of Electrocardiology, 44(6), 689-693.
Kodoth, V ; Castro, NC ; Glover, BM ; Anderson, JMCC ; Escalona, OJ ; Lau, E ; Manoharan, G. / Waveform optimisation for internal cardioversion of atrial fibrillation. In: Journal of Electrocardiology. 2011 ; Vol. 44, No. 6. pp. 689-693.
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Kodoth, V, Castro, NC, Glover, BM, Anderson, JMCC, Escalona, OJ, Lau, E & Manoharan, G 2011, 'Waveform optimisation for internal cardioversion of atrial fibrillation', Journal of Electrocardiology, vol. 44, no. 6, pp. 689-693.

Waveform optimisation for internal cardioversion of atrial fibrillation. / Kodoth, V; Castro, NC; Glover, BM; Anderson, JMCC; Escalona, OJ; Lau, E; Manoharan, G.

In: Journal of Electrocardiology, Vol. 44, No. 6, 2011, p. 689-693.

Research output: Contribution to journalArticle

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T1 - Waveform optimisation for internal cardioversion of atrial fibrillation

AU - Kodoth, V

AU - Castro, NC

AU - Glover, BM

AU - Anderson, JMCC

AU - Escalona, OJ

AU - Lau, E

AU - Manoharan, G

PY - 2011

Y1 - 2011

N2 - Introduction: A novel atrial defibrillator was developed at the Royal Victoria Hospital in collaboration with the Nanotechnology and Integrated Bio-Engineering Centre (NIBEC), University of Ulster. This device is powered by an external pulse of radiofrequency (RF) energy and designed to cardiovert using low tilt monophasic (LTMW) and low tilt biphasic waveform (LTBW), 12 ms pulse width. This study compared the safety and efficacy of LTMW with LTBW for transvenous cardioversion of atrial fibrillation (AF).Methods: Patients with persistent AF and with previous history of failed external cardioversion were randomised to LTMW or LTBW. Warfarin INR level was maintained in between 2-3 for 4 weeks prior cardioversion. St Jude’s defibrillating catheter was positioned in the distal coronary sinus and right atrium and connected to the defibrillator via a junction box. After a test shock using a dummy load, patient was cardioverted in a step up progression from 50V to 300V. Shock success was defined as return of sinus rhythm for >/=30 seconds. If cardioversion was unsuccessful at peak voltage patient was crossed over to the other arm of waveform type and cardioverted at peak voltage. Results: Thirty patients (50%) were equally randomised to LTBW and LTMW. Seven out of 15 (46%) cardioverted to sinus rhythm with LTBW and 1/15 (6%) with LTMW (p

AB - Introduction: A novel atrial defibrillator was developed at the Royal Victoria Hospital in collaboration with the Nanotechnology and Integrated Bio-Engineering Centre (NIBEC), University of Ulster. This device is powered by an external pulse of radiofrequency (RF) energy and designed to cardiovert using low tilt monophasic (LTMW) and low tilt biphasic waveform (LTBW), 12 ms pulse width. This study compared the safety and efficacy of LTMW with LTBW for transvenous cardioversion of atrial fibrillation (AF).Methods: Patients with persistent AF and with previous history of failed external cardioversion were randomised to LTMW or LTBW. Warfarin INR level was maintained in between 2-3 for 4 weeks prior cardioversion. St Jude’s defibrillating catheter was positioned in the distal coronary sinus and right atrium and connected to the defibrillator via a junction box. After a test shock using a dummy load, patient was cardioverted in a step up progression from 50V to 300V. Shock success was defined as return of sinus rhythm for >/=30 seconds. If cardioversion was unsuccessful at peak voltage patient was crossed over to the other arm of waveform type and cardioverted at peak voltage. Results: Thirty patients (50%) were equally randomised to LTBW and LTMW. Seven out of 15 (46%) cardioverted to sinus rhythm with LTBW and 1/15 (6%) with LTMW (p

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JO - Journal of Electrocardiology

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Kodoth V, Castro NC, Glover BM, Anderson JMCC, Escalona OJ, Lau E et al. Waveform optimisation for internal cardioversion of atrial fibrillation. Journal of Electrocardiology. 2011;44(6):689-693.