Internal cardioversion shortens periods of postoperative atrial fibrillation: results of a prospective, multicenter trial

Abstract

Aim of the study: Atrial fibrillation (AF) commonly occurs following open heart surgery especially in the high-risk group of old patients with reduced left ventricular function. Via Syncrus heart wires implanted on the left and right atrium internal cardioversion shocks can be applied. This prospective nonrandomized multicenter study compares duration of AF periods and clinical outcome in patients treated with Syncrus wires to a control group treated conventionally.

Methods: In 88 patients Syncrus heart wires were implanted. Upon detection of AF antiarrhythmic medication was started for at least 6 hours followed by internal cardioversion. The results of this treatment were compared to a control group of 86 patients with an identical risk profile.

Results: In the Syncrus group 53.4% of patients suffered from postoperative AF compared with 50.0% in the control group. Internal cardioversion led to restoration of sinus rhythm in 60% of patients at the first series of shocks (mean energy 7.7 +/- 1.3 J) and 95.8% with the second series (mean energy 8.6 +/- 0.5 J). Length of AF periods was 12.4 +/- 7.2 hours in the Syncrus group versus 42.9 +/- 19.6 hours in control patients.

Conclusions: Internal cardioversion using Syncrus heart wires demonstrated effectiveness in treating postoperative AF. Especially, length of AF periods could be diminished by the system with the expectation of reduction in hospital length of stay.