Cor Vasa 2004, 45(5):215-219
The efficacy of biphasic and monophasic electrical cardioversion in patients with supraventricular tachycardia
- II. interní klinika, Všeobecná fakultní nemocnice a 1. lékařská fakulta Univerzity Karlovy, Praha, Česká republika
Electrical cardioversion (EC) is a basic therapeutic procedure in patients with supraventricular tachycardia (SVT). At present, biphasic discharges are generally believed to be more effective compared with conventional, monophasic ones.
Aim:
To compare the efficacy of EC using biphasic and monophasic types of discharge in SVT patients.
Method:
A total of 141 patients with various types of SVT referred to EC were randomized to delivery of a biphasic (BF group) or a monophasic (MF group) discharge. The recommended energy of the first discharge was 150 J with atrial fibrillation, and 100 J with other types of SVT in either group.
Results:
The mean age of patients was 67.9 ± 11.3 years. None of the patients had more than 4 discharges delivered. Biphasic and monophasic EC was performed in 71 and 70 patients, respectively. The most frequent indication was atrial fibrillation (63.8%). The EC was considered effective only if sinus rhythm had been achieved. No significant difference was noted between BF and MF groups in EC efficacy (87.3% and 88.4%; p = 0.8446). However, patients receiving a biphasic discharge required significantly lower cumulative energy to achieve sinus rhythm compared with MF patients (265 ± 241 and 369 ± 278; p = 0.0017). Moreover, the likelihood of success of EC when using cumulative energy £ 200 J was higher in the BF group (69.0% and 50.7%; p = 0.0408). Long-term pretreatment with antiarrhythmic drugs was an independent predictor of success of EC.
Conclusion:
The efficacy of biphasic EC is comparable with that of monophasic EC. However, the cumulative energy applied during a biphasic discharge is lower, and use of this type of discharge is associated with a higher likelihood of success if using cumulative energy £ 200 J.
Keywords: Electrical conversion; Biphasic discharge; Monophasic discharge; Efficacy
Published: May 1, 2004 Show citation