Analysis of AF Cardioversion Waveforms for Optimised Shock Protocols
Research type
Research Study
Full title
Analysis of AF Cardioversion Waveforms for Optimised Shock Protocols
IRAS ID
144805
Contact name
David McEneaney
Contact email
Sponsor organisation
Southern Health and Social Services Trust
Research summary
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias; accounting for 30-40% of all hospitalizations due to arrhythmias. Atrial fibrillation (AF) is associated with increased risk of stroke leading to significant morbidity and mortality (1-4). Consequently, the need for the continued investigations and improvements in AF associated therapies remains self evident.
Synchronised internal atrial defibrillation (intracardiac cardioversion) is a procedure which employs an electrically conductive catheter to deliver a low energy electrical shock between the distal coronary sinus and the right atrial appendage; thereby attempting to restore normal or sinus rhythm the heart. Synchronised internal electrical cardioversion of atrial fibrillation has been shown to be effective and safe in a number of clinical studies (1-6). Historically, a small number of high energy shocks (20J) has been the favored technique used to internal cardiovert AF patients, however, recent publications have suggested that multiple low energy electrical shocks may give rise to reduced cardioversion thresholds (7,8,14). Yet there still exists a paucity of studies comparing single versus multi-shock AF treatment protocols.
The aim of this study is therefore to address the identified knowledge gap by: (i) comparing the efficacy of two different intracardiac AF cardioversion protocols; an energy step-up shock protocol versus a single high energy electrical shock, (ii) mathematical extraction of novel electrical parameters (ECG derived dominant atrial fibrillation frequency, dynamic cardiac impedance variation and shock waveform spectral content) from the cardioversion shock waveform that can be used to scientifically investigate if a correlation of any of these parameters to clinical outcomes exists.
The outcomes of this work will therefore have the potential to impact current medical practice by providing insight to key factors that govern efficacy of the internal atrial defibrillation treatment protocols presently used and in so doing provide a scientific basis for the further refinement and optimisation of same.
REC name
HSC REC B
REC reference
14/NI/1066
Date of REC Opinion
3 Sep 2014
REC opinion
Further Information Favourable Opinion