A prospective randomized study of the clinical efficacy and safety of transvenous cardioversion for termination of XXXX .

@entity1 @entity1165 @entity66 @entity1457 @entity591 @entity299 @entity943 @entity1168
The clinical efficacy and safety of transvenous cardioversion for termination of sustained @entity1165 ( @entity1165 ) were examined by a prospective randomized study design in 22 @entity1 (19 @entity1 , three @entity1 ; mean age 64 +/- 9 years) with @entity299 and sustained @entity1165 . @entity1 were randomly assigned to undergo an incremental low-energy protocol from 0.03 to 2.2 J (group A, 11 @entity1 ) or an incremental high-energy protocol from 0.5 to 10.0 J (group B, 11 @entity1 ). Transvenous cardioversion was performed during electrophysiologic studies in the control (drug-free) state and during serial antiarrhythmic drug testing in all @entity1 . Both groups were comparable for @entity66 and functional status, and electrophysiologic parameters. A total of 77 episodes of @entity1165 (group A, 45; group B, 32) were analyzed. The overall efficacy of transvenous cardioversion for termination of @entity1165 was 62% (group A 56% vs group B 72%; p less than .01). Antiarrhythmic drug therapy did not significantly enhance efficacy of transvenous cardioversion (control 59% vs drug 65%; p greater than .2). Stepwise discriminant analysis correlated successful transvenous cardioversion with longer @entity1165 cycle length (p less than .0005), higher energy (p less than .025), lower energy waveform tilt (p less than .025), shorter time to initial cardioversion attempt (p less than .025), and shorter QRS duration in sinus rhythm (p less than .05). Acceleration of @entity1165 was frequent (8% incidence per @entity1457 ). Thirty-one percent of all @entity1457 were terminated because of this complication. After cardioversion, transient @entity943 were common ( @entity1168 23%, supraventricular @entity591 12%). Displacement of electrode catheters after transvenous cardioversion was uncommon (3%).(ABSTRACT TRUNCATED AT 250 WORDS)
