{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:53:17Z","timestamp":1787017997817,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1997,7]]},"abstract":"<jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    Recent studies have suggested that induced atrial fibrillation (AF) could be successfully terminated by using a two-catheter electrode system and low energy (&lt;400 V). This study evaluated the efficacy and safety of low-energy cardioversion in spontaneous chronic and paroxysmal AF.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods and Results<\/jats:italic>\n                    Forty-two consecutive patients with spontaneous AF underwent low-energy electrical cardioversion. AF was chronic (\u22651 month) with a mean duration of 9\u00b119 months in 28 patients (group I) or paroxysmal with a history of recurrent attacks and a mean duration of the present episode of 7\u00b116 days in 14 patients (group II). An underlying heart disease was present in 28 patients. A 3\/3-ms biphasic shock was delivered between catheters positioned in the right atrium and the coronary sinus in 32 patients. In 10 patients, the left pulmonary artery branch was used. The catheters were connected to a custom external defibrillator. The shocks were synchronized to the R wave. Following a test shock of 60 V, the energy was increased in 40-V steps until a maximum of 400 V or restoration of sinus rhythm. Sinus rhythm was restored in 22 of the 28 patients (78%) of group I by using a mean leading-edge voltage of 297\u00b157 V (mean energy, 3.3\u00b11.3 J) and in 11 of 14 patients (78%) of group II by using a mean leading-edge voltage of 223\u00b141 V (mean energy, 1.8\u00b10.7 J). The energy required for terminating chronic AF was significantly (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;.001) higher than that required for terminating paroxysmal AF. Among the other variables studied, the duration of AF significantly affected the successful voltage. Ventricular proarrhythmia occurred in 1 patient with atrial flutter due to an unsynchronized shock. Of the 22 patients of group I in whom sinus rhythm was restored, 14 (63%) remained in sinus rhythm with a mean follow-up of 9\u00b13 months. Pain level showed a good correlation with increasing voltage. However, a marked interindividual variation was noted.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    Atrial defibrillation using low energy between two intracardiac catheters with an electrical field between the right and left atria and the protocol used is feasible in patients with persistent spontaneous AF. The technique is safe provided synchronization to the R wave is achieved. A low recurrence rate of AF was seen in patients in whom sinus rhythm was restored.\n                  <\/jats:p>","DOI":"10.1161\/01.cir.96.1.253","type":"journal-article","created":{"date-parts":[[2012,6,11]],"date-time":"2012-06-11T20:41:02Z","timestamp":1339447262000},"page":"253-259","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":79,"title":["Low-Energy Cardioversion of Spontaneous Atrial Fibrillation"],"prefix":"10.1161","volume":"96","author":[{"given":"Samuel","family":"Le\u0301vy","sequence":"first","affiliation":[{"name":"From the Cardiology Division, School of Medicine, University of Marseilles, Marseilles, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Ricard","sequence":"additional","affiliation":[{"name":"From the Cardiology Division, School of Medicine, University of Marseilles, Marseilles, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Gueunoun","sequence":"additional","affiliation":[{"name":"From the Cardiology Division, School of Medicine, University of Marseilles, Marseilles, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence","family":"Yapo","sequence":"additional","affiliation":[{"name":"From the Cardiology Division, School of Medicine, University of Marseilles, Marseilles, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Trigano","sequence":"additional","affiliation":[{"name":"From the Cardiology Division, School of Medicine, University of Marseilles, Marseilles, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chadia","family":"Mansouri","sequence":"additional","affiliation":[{"name":"From the Cardiology Division, School of Medicine, University of Marseilles, Marseilles, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franck","family":"Paganelli","sequence":"additional","affiliation":[{"name":"From the Cardiology Division, School of Medicine, University of Marseilles, Marseilles, France."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198204293061703"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.82.4.2144796"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90003-6"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.87.5.8491035"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.87.5.8491023"},{"key":"e_1_3_2_6_2","first-page":"928","volume":"16","year":"1993","unstructured":"Keane D, Sulke N, Cooke R, Jackson G, Sowton E. Endocardial cardioversion of atrial flutter and fibrillation. PACE Pacing Clin Electrophysiol. 1993;16:928. Abstract.","journal-title":"PACE Pacing Clin Electrophysiol"},{"key":"e_1_3_2_7_2","unstructured":"Johnson EE Yarger MD Wharton JM. Monophasic and biphasic waveforms for low-energy internal cardioversion of atrial fibrillation in humans. Circulation. 1993;88(suppl I):I-592. Abstract."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1994.tb01462.x"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)00555-5"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.89.1.8281677"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(88)90428-7"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.86.5.1423954"},{"key":"e_1_3_2_13_2","first-page":"377","volume":"84","year":"1991","unstructured":"Chauvin M, Koenig A, Theolade R, Brechenmacher C. La place du choc \u00e9lectrique interne dans le traitement de la fibrillation auriculaire permanente: r\u00e9sultats pr\u00e9liminaires \u00e0 propos de 28 cas. Arch Mal Coeur. 1991;84:377-382.","journal-title":"Arch Mal Coeur"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1991.tb02730.x"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1994.tb01137.x"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.96.1.253","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T12:12:19Z","timestamp":1715515939000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.96.1.253"}},"subtitle":["Immediate and Long-term Results"],"short-title":[],"issued":{"date-parts":[[1997,7]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1997,7]]}},"alternative-id":["10.1161\/01.CIR.96.1.253"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.96.1.253","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1997,7]]},"assertion":[{"value":"1995-12-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1997-01-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1997-07-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}