- Poster presentation
- Open Access
Biphasic DC shock as a first-line therapy in recent-onset stable atrial fibrillation in the emergency department
© BioMed Central Ltd. 2007
- Published: 22 March 2007
- Atrial Fibrillation
- Emergency Department
- Sinus Rhythm
- Antiarrhythmic Drug
To evaluate the efficacy of early electric cardioversion (EC) with a biphasic defibrillator and the impact on atrial function in recent-onset atrial fibrillation (AF).
Number of patients
Sinusal rhythm restoration
Left atrial ejection fraction two chambers
35 (P = 0.02)
Left atrial ejection fraction four chambers
35 (P = 0.02)
Left ventricular ejection fraction
54 (P = NS)
A wave (m/s)
DC shock was successful for all patients (100%) and in 19/21(90.4%) at first shock. There was a significant increase in atrial function with the reappearance of the A wave. There were no thromboembolic complications. After 7 days, results showed that 19/21 (90.4%) patients were in SR.
Early electric cardioversion in the emergency department setting is a simple technique that allows the restoration of SR without complications. The biphasic waveform uses lower energy with a positive impact on atrial function. Higher energy can cause transient tissue damage due to electroporation that can affect the outcome of defibrillation therapy being both pro-arrhythmic and anti-arrhythmic. The recovery of atrial function is also due to the short duration of arrhythmia. The early cardioversion avoids atrial remodelling and allows a longer duration of SR.