P456External electrical cardioversion in patients with cardiac implantable electronic devices: is it safe and is immediate device interrogation necessary?

Pluymaekers, NAHA; Dudink, EAMP; Boersma, L; Erküner, Ö.; Gelissen, Marloes; Dijk, Vincent van; Wijffels, Maurits C.E.F.; Dinh, Trang; Vernooy, Kevin; Crijns, Hjgm; Balt, Jippe C.; Luermans, JGLM

doi:10.1093/europace/euy015.265

Cited by 3 publications

(6 citation statements)

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“…Our study findings of lead changes were comparable to the observations of Lüker J. et al in 2018 with 11/1809 (0.6%) shockrelated adverse events (21). But this approach was opposed by Pluymaeker et al in 2018, who challenged the need for immediate post-shock device Interrogations (23). Overall, ECV seems safe in the majority of CIED patients with a low-risk of shockrelated immediate or delayed complications.…”

Section: Post-cardioversion Device Interrogationssupporting

confidence: 87%

“…However, various types of PM and ICD complications have been reported over the last five decades (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Despite clinical relevance for uninterrupted PM and ICD function in pacing-dependent patients, newer data for patients with modern PMs and ICDs undergoing ECV treatment is limited (21)(22)(23).…”

Section: Abbreviationsmentioning

confidence: 99%

“…The clinical ECV setup with anteriorposterior shock-pads orientation and left-sided PM generator is presented in Figure 2. (22,23). The studies varied in study design however, none of the studies showed clinically significant generator or lead changes.…”

Section: Cied Complications Following Cardioversionmentioning

confidence: 99%

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External cardioversion in patients with cardiovascular implantable electronic devices: An epidemiological and experimental study series

Elgaard

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Section: Post-cardioversion Device Interrogationssupporting

confidence: 87%

Section: Abbreviationsmentioning

confidence: 99%

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External cardioversion in patients with cardiovascular implantable electronic devices: An epidemiological and experimental study series

Elgaard

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“…Se ha demostrado que la descarga de energía fija y máxima desde el inicio es más efectiva en comparación con las descargas de energía de baja que se suben de forma escalonada, sin encontrar diferencias en la seguridad 34 . En portadores de un desfibrilador automático implantable (DAI), la CVE anteroposterior parece ser segura y evita el daño del dispositivo, incluso, puede ser preferible a la cardioversión interna realizada con el DAI sin necesidad de una interrogación inmediata del dispositivo 35 . En algunas publicaciones, como el RAFF2, se realizó una comparación aleatoria, ciega y controlada con placebo de cardioversión eléctrica previa terapia farmacológica.…”

Section: Cardioversión Eléctricaunclassified

Tratamiento de la fibrilación auricular en el servicio de urgencias: una revisión práctica de la literatura

Aguilar-Molina,

Montoya-Duque,

Betancur-Salazar

et al. 2023

RCCAR

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La fibrilación auricular es la arritmia cardíaca más frecuente del mundo y, de igual manera, es la arritmia predominante en los servicios de urgencias. Cada vez hay más prevalencia de esta enfermedad y, en consecuencia, mayores probabilidades de que los médicos en los servicios de urgencias se enfrenten a ella. Las estrategias de tratamiento estándar de la fibrilación auricular suelen ser "conservadoras" y tradicionalmente han sido el control de la frecuencia, la anticoagulación y la hospitalización. La principal motivación de este tipo de estrategia es prevenir el accidente cerebrovascular. Cuando pasa el tiempo y se produce remodelado atrial, la fibrilación auricular es cada vez más refractaria a la conversión al ritmo sinusal y cuanto más tiempo persiste y el daño cardíaco estructural aumenta, más se incrementa la duración de la fibrilación auricular. Así, en el servicio de urgencias, el manejo adecuado de un primer episodio o de una complicación, puede minimizar costos y reducir exposiciones innecesarias a terapias inadecuadas. Esta revisión aborda el manejo de la fibrilación auricular en el servicio de urgencias con base en la evidencia que se tiene disponible en el momento.

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“…Despite minor changes in lead impedances, pacing thresholds, and sensing measurements they concluded that ECV seems safe in CIED patients and challenging the need for immediate post-shock device interrogations. 10,13 Previously, routine post-shock CIED interrogations were recommended in the American (AHA/ACC/HRS) and European (ESC) guidelines, but in the versions routine post-shock device interrogation is not direct mentioned. 14,15 This study aims to investigate ECV-related complications and impact on contemporary CIEDs.…”

Section: Introductionmentioning

confidence: 99%

External cardioversion of atrial fibrillation and flutter in patients with cardiac implantable electrical devices

Elgaard

Dinesen

Riahi

et al. 2022

Pacing Clinical Electrophis

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Background Atrial fibrillation and flutter are often treated with external electrical cardioversion (ECV) in patients with potentially electrically sensitive cardiovascular implantable electronic devices (CIED). Long‐term follow‐up data on contemporary CIED undergoing ECV is sparse. The aim is to investigate shock‐related complications and impact on CIEDs. Methods All ECV procedures from 2010 to 2020 in patients with CIED performed at a tertiary university hospital were identified in the Danish National Patient Registry. Changes in device measurements after ECV were retrospectively studied and procedure‐related complications were identified by review of medical records. Results We analyzed 763 ECV procedures in 372 patients, median device implant time 1.9 years. The mean age of patients was 69.9 ± 9.9 years of which 73.4% were men. We identified two cases of device programming changes and four cases of premature battery depletion (≤3 years after device implant). Minor changes in device measurements were found for impedances, sensing, and pacing thresholds. No patients died due to ECV‐related device dysfunctions within the first 12 months after cardioversions. Conclusion External cardioversion in patients with contemporary pacemakers and implantable cardioverter‐defibrillators seems safe in the majority of patients. Clinically important changes in device function following cardioversion were rarely observed but may be critical for device function. In an observational study, causality between cardioversion and device dysfunction cannot be established. For patient safety, we suggest that routine device interrogation after cardioversion still should be part of standard care.

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P456External electrical cardioversion in patients with cardiac implantable electronic devices: is it safe and is immediate device interrogation necessary?

Cited by 3 publications

References 0 publications

External cardioversion in patients with cardiovascular implantable electronic devices: An epidemiological and experimental study series

External cardioversion in patients with cardiovascular implantable electronic devices: An epidemiological and experimental study series

Tratamiento de la fibrilación auricular en el servicio de urgencias: una revisión práctica de la literatura

External cardioversion of atrial fibrillation and flutter in patients with cardiac implantable electrical devices

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