The aim of the study was to evaluate the effect of preshock atrial pacing on the @entity955 threshold (DFT) during internal cardioversion of AF. The implantable @entity955 has been added to the therapeutic options for @entity1 with recurrent episodes of persistent AF. Although the device is efficient in restoring sinus rhythm, @entity1 discomfort is a limitation. Methods that lower the ADFT are needed. Eleven @entity1 with AF underwent internal cardioversion. In a randomized, crossover design, ADFT testing was performed, applying a step-up protocol starting at 100 V. Rapid atrial pacing was performed with a right atrial catheter for 20 seconds at 90% of the average cycle length of the fibrillatory waves and was immediately followed by a biphasic defibrillation shock. At each energy level, pacing + shock was compared to shock only, until the level at which sinus rhythm was restored by both modes. The step-up protocol was thereafter repeated using the inverse sequence of the two modes. A total of 19 ADFTs were obtained. For 10 the ADFT was lower with pacing + shock, in 4 equal and in 5 higher, than with shock only. The ADFT (mean +/- SD) with pacing + shock was 260 +/- 84 V(3.4 +/- 2.9 J) and did not differ from shock only: 268 +/- 85 V(3.8 +/- 3.0 J) (P > 0.05). The coefficient of variation and the coefficient of reproducibility for pacing + shock was 16% and 60 V, respectively, and for shock only 17% and 61 V. Rapid atrial pacing did not influence the internal ADFT in AF. The randomized, crossover protocol used was reproducible between different modes, and seems useful when testing the impact of different interventions on the ADFT.

Rapid atrial pacing does not decrease the XXXX threshold.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity955 :: ('MESH:D001281', 'Disease') :: ['atrial defibrillation', 'atrial defibrillator']
@entity955 :: (MESH:D001281,Disease) :: ['atrial defibrillation']
