Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2023 Feb;46(2):108-113.
doi: 10.1111/pace.14616. Epub 2022 Nov 21.

External cardioversion of atrial fibrillation and flutter in patients with cardiac implantable electrical devices

Anders Fyhn Elgaard  1   2 , Pia Thisted Dinesen  3 , Sam Riahi  1   2 , John Hansen  4 , Søren Lundbye-Christensen  5 , Anna Margrethe Thøgersen  1 , Jacob Moesgaard Larsen  1   2
Affiliations
Observational Study

External cardioversion of atrial fibrillation and flutter in patients with cardiac implantable electrical devices

Anders Fyhn Elgaard et al. Pacing Clin Electrophysiol. 2023 Feb.

Abstract

Background: Atrial fibrillation and flutter are often treated with external electrical cardioversion (ECV) in patients with potentially electrically sensitive cardiovascular implantable electronic devices (CIED). Long-term follow-up data on contemporary CIED undergoing ECV is sparse. The aim is to investigate shock-related complications and impact on CIEDs.

Methods: All ECV procedures from 2010 to 2020 in patients with CIED performed at a tertiary university hospital were identified in the Danish National Patient Registry. Changes in device measurements after ECV were retrospectively studied and procedure-related complications were identified by review of medical records.

Results: We analyzed 763 ECV procedures in 372 patients, median device implant time 1.9 years. The mean age of patients was 69.9 ± 9.9 years of which 73.4% were men. We identified two cases of device programming changes and four cases of premature battery depletion (≤3 years after device implant). Minor changes in device measurements were found for impedances, sensing, and pacing thresholds. No patients died due to ECV-related device dysfunctions within the first 12 months after cardioversions.

Conclusion: External cardioversion in patients with contemporary pacemakers and implantable cardioverter-defibrillators seems safe in the majority of patients. Clinically important changes in device function following cardioversion were rarely observed but may be critical for device function. In an observational study, causality between cardioversion and device dysfunction cannot be established. For patient safety, we suggest that routine device interrogation after cardioversion still should be part of standard care.

Keywords: CIED; ICD; Pacemaker; defibrillation; device complication; external cardioversion; interrogation.

PubMed Disclaimer

References

REFERENCES

    1. Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010. Study Circul 2014;129:837-847.
    1. Ball J, Carrington MJ, McMurray JJ, Stewart S, Atrial fibrillation: profile and burden of an evolving epidemic in the 21st century. Int J Cardiol. 2013;167:1807-1824.
    1. Israel CW, Neubauer H, Olbrich HG, Hartung W, Treusch S, Hohnloser SH, Incidence of atrial tachyarrhythmias in pacemaker patients: results from the Balanced Evaluation of Atrial Tachyarrhythmias in Stimulated patients (BEATS) study. Pacing Clin Electrophysiol. 2006;29:582-588.
    1. Swiryn S, Orlov MV, Benditt DG, DiMarco JP, Lloyd-Jones DM, Karst E, et al. Clinical implications of brief device-detected atrial tachyarrhythmias in a cardiac rhythm management device population: results from the registry of atrial tachycardia and atrial fibrillation episodes. Circulation. 2016;134:1130-1140.
    1. Brandes A, Crijns H, Rienstra M, Kirchhof P, Grove EL, Pedersen KB, et al. Cardioversion of atrial fibrillation and atrial flutter revisited: current evidence and practical guidance for a common procedure. Europace. 2020;22:1149-1161.

Publication types