Cardioversion

[Gunter]

It appears that electric cardioversion can be attempted several times to get back to sinus rythm for atrial fibrillation problems. I have had one conversion which lasted about 30 hours. Here are my questions:

1.) Does the percentage of successful and sustained conversions to sinus rythm change with with the number of trials, i.e. are attempts no. 2 or 3 etc. more likely or less likely to succeed?

2.) Does the use of chemical conversion agents (e.g. tambocor or procaidamine) administered during or after electrical conversion confuse the apparent results of electrical conversion because, on a scientific basis chemical and electrical conversions appear to be completely different processes?

3.) Does the short-term use of chemical conversion agents during electrical cardioversion help sustain electrical conversion?

4.) When attempting electrical cardioversions, what can be done to optimize the success of longterm sustained sinus rythm if follow-up long-term medication is undesirable. For example, should attempt no. 2 be made as soon as it is clear that the apparent success of attempt no. 1 has dissipated?

Thanks again for your time.

[CCF CARDIO MD JMF]

These will depend on whether you are on medications that will help the cardioversion hold.  You may wish to use Iva's case as an example.

[Gunter]

Dear Dr. JMF:

Please elaborate briefly on your answer to my first question: What are you telling me when you say that the success of multiple electro cardioversions 'depends on the therapy' I am on?

Thanks again

[iva]

I had the conversion it lasted one week. I was put on coumadin again and felt I may live with the atrial fib  to my surprise after three months my heat went back in rythm with just the help of medication, Amiodarone, and Atenolol, I had been on Quinidine four years that quit working, i was on Rythmol that one week and it failed me,,I am very happy about this, my Dr was as happy as I..Good luck.

[CCF CARDIO MD JMF]

In response to your questions.

Does the percentage of successful and sustained conversions to sinus rythm change with with the number of
     trials, i.e. are attempts no. 2 or 3 etc. more likely or less likely to succeed? This depends on the therapy you are on and  your anatomy.

     2.) Does the use of chemical conversion agents (e.g. tambocor or procaidamine) administered during or after
     electrical conversion confuse the apparent results of electrical conversion because, on a scientific basis chemical
     and electrical conversions appear to be completely different processes? No

     3.) Does the short-term use of chemical conversion agents during electrical cardioversion help sustain electrical
     conversion? Yes

     4.) When attempting electrical cardioversions, what can be done to optimize the success of longterm sustained
     sinus rythm if follow-up long-term medication is undesirable. For example, should attempt no. 2 be made as soon
     as it is clear that the apparent success of attempt no. 1 has dissipated? Short term anti arrhythmics may stabilize the atrium over the initial vulnerable period of the first 6 to 8 weeks.