Loading...
Case reports and a small series suggested that cardioversion was risky for patients with older implanted pacemakers, causing device and lead failure and, rarely, myocardial damage or death. Investigators in Germany prospectively studied the safety of elective cardioversion of atrial fibrillation (AF) in patients with modern pacemakers who were referred to a cardiology clinic for cardioversion.
Forty-four patients with dual-chamber pacemakers were randomized to monophasic or biphasic cardioversion. AF had been present for a median of 21 days (range, 1 to 1359). Before cardioversion, all patients either had been taking anticoagulants for at least 3 weeks or underwent transesophageal echocardiography to rule out thrombus. External electrodes we…