Esophageal Electrical Cardioversion of Atrial Fibrillation: When Esophagus Gives a Help to Cardiologists

Abstract

Atrial fibrillation is a common clinical disease especially in the elderly and in patients with organic heart disease. Electrical cardioversion is the first choice therapeutic approach for patients in which sinus rhythm could improve the quality of life and where the maintenance of sinus rhythm is considered likely. There are different techniques to perform an electrical cardioversion, each with specific indications, advantages, and limitations. The method most frequently used to restore sinus rhythm is external direct current cardioversion; however, this technique has some disadvantages, since it requires a high energy and usually general anesthesia. Esophageal cardioversion is an alternative method to obtain restoration of sinus rhythm, warranting acute and long-term results absolutely comparable with those obtained by the conventional transthoracic technique, especially in obese and COPD patients with high thoracic impedance for whom the standard technique may be less effective.

Geophysical monitoring and reactive transport modeling of ureolytically-driven calcium carbonate precipitation

“…The arid western U.S. is an example of such an environment [ 9 ]. In addition to metal sequestration, enhanced calcium carbonate precipitation has many other potential applications, such as providing cementation for soil strengthening [ 10 ], and a long term sink for atmospheric carbon associated with CO 2 storage/sequestration within geological media [ 11 ].…”

Implanted Devices and Atrial Fibrillation

“…The most important is a low energy requirement thanks to proximity of the oesophagus to the left atrium which warrants a lower energy dispersion and a lower defibrillation impedance. For this reason its safety has been demonstrated in patients with implantable devices [30]. In patients with ICDs, a programmed ventricular ICD discharge could be another option for a quick and safe cardioversion.…”

Current Issues and Recent Advances in Pacemaker Therapy

“…Most current leads are at least bipolar with size and flexibility similar to previous unipolar leads. The advantage of multiple electrodes is the possibility of electrical "repositioning" when high pacing threshold or phrenic nerve stimulation is encountered (Gurevitz, 2005 andForleo, 2011). (Figure 3) If the vein is tortuous, a stiffer wire or buddy wire may be used with caution, as the wall thickness and tear resistance of coronary veins is much less compared to coronary arteries.…”