Transesophageal Cardioversion and Defibrillation

Efficacy of intravenous propafenone in termination of atrial flutter by overdrive transesophageal pacing previously ineffective.

D'Este D, Bertaglia E, Mantovan R, Zanocco A, Franceschi M, Pascotto P. Divisione di Cardiologia, O.C. Mirano. Am J Cardiol 1997;79(4):500-2. Fifty patients with symptomatic type I atrial flutter in whom termination of the arrhythmia with transesophageal stimulation was unsuccessful were randomized to undergo a repeat procedure after intravenous propafenone (n = 25) or placebo (n = 25). Immediate sinus rhythm recovery rate was 36% in the propafenone group and 4% in the placebo group (p = 0.005), indicating that intravenous propafenone increases the rate of successful transesophageal stimulation and can be used when a first attempt at conversion is ineffective.

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