Paravolidakis K E, Kolettis T M, Theodorakis G N, Paraskevaidis I A, Apostolou T S, Kremastinos D T
2nd Department of Cardiology and General Hospital of Nikea, Athens, Greece.
J Interv Card Electrophysiol. 1998 Sep;2(3):249-53. doi: 10.1023/a:1009732903788.
To evaluate the safety and long-term efficacy of internal transcatheter cardioversion, forty patients with chronic, lone atrial fibrillation were studied. The patients were randomised to internal transcatheter cardioversion or to conventional external cardioversion. In cases where the procedure was unsuccessful, cross-over to the alternate method was performed. Oral anticoagulation therapy was started three weeks prior to the procedure and was maintained for another three weeks following successful cardioversion. Sinus rhythm was restored in 16/18 patients (88%) in the internal cardioversion group, versus 9/22 patients (40%) in the external cardioversion group (p < 0.01). In addition, 8/13 (61%) patients who were crossed-over to internal cardioversion were successfully cardioverted to sinus rhythm. In contrast, both patients who were crossed-over to external cardioversion remained in atrial fibrillation. During a mean follow-up period of 23 months, 13 (39.3%) patients maintained sinus rhythm. Using the intention to treat principle, the recurrence rate was not statistically different between the two methods. It is concluded that internal cardioversion is more effective in acutely restoring sinus rhythm compared to external cardioversion. However, both methods have similar long-term recurrence rates.
为评估经导管心内电复律的安全性和长期疗效，对40例慢性孤立性心房颤动患者进行了研究。患者被随机分为经导管心内电复律组或传统体外电复律组。若手术不成功，则采用交替方法。术前3周开始口服抗凝治疗，并在成功复律后再维持3周。心内电复律组16/18例患者（88%）恢复窦性心律，而体外电复律组9/22例患者（40%）恢复窦性心律（p<0.01）。此外，转至心内电复律的13例患者中有8例（61%）成功复律为窦性心律。相比之下，转至体外电复律的2例患者均仍为房颤。在平均23个月的随访期内，13例（39.3%）患者维持窦性心律。采用意向性治疗原则，两种方法的复发率无统计学差异。结论是，与体外电复律相比，心内电复律在急性恢复窦性心律方面更有效。然而，两种方法的长期复发率相似。
