Universität zu Köln

Lueker, J., Sultan, A., Plenge, T., van den Bruck, J., Heeger, C. -H., Meyer, S., Mischke, K., Tilz, R. R., Vollmann, D., Noelker, G., Schaeffer, B., Willems, S. and Steven, D. (2018). Electrical cardioversion of patients with implanted pacemaker or cardioverter-defibrillator: results of a survey of german centers and systematic review of the literature. Clin. Res. Cardiol., 107 (3). S. 249 - 259. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Aims A relevant number of patients presenting for electrical cardioversion carry a pacemaker (PM) or ICD. Case reports suggest a potential hazard of external cardioversion/defibrillation. The incidence of shock related device complications is unknown. No guidelines or recommendations by international medical societies for a cardioversion protocol of cardiovascular implantable electronic device (CIED) patients exist. We conducted a nationwide survey to gather real-world clinical data on the current clinical approach towards these patients during electrical cardioversion and to estimate the incidence of shock-related complications. Methods and results Ninety hospitals with > 380 ECV in 2014 were identified from mandatory hospital quality reports and 60 were randomly selected. All centers were provided with a standardized questionnaire on the general proceedings and complications during electrical cardioversion of pacemaker, ICD and CRT patients (CIED patients). Thirty-two centers (53%) participated in the survey. In total, 16,554 ECV were reported (534 +/- 314 per center). Biphasic cardioversion with a first shock energy of >= 150 J via adhesive patches in antero-posterior orientation was preferred by most centers (78%). Eleven percent (n = 1809) of pts were reported to carry a PM/ICD. The ECV protocol was heterogeneous among centers. Complications associated with electrical cardioversion were reported in 11/1809 patients (0.6%), all were transitory elevations of pacing thresholds. Conclusions In this nationwide snapshot survey of cardioversion procedures in Germany, approximately 11% of patients presenting for elective electrical cardioversion were pacemaker or ICD carriers. Cardioversion protocols in these patients are heterogeneous throughout centers and mostly not in accordance with recommendation of the German Cardiac Society. Complications associated with external electrical cardioversion are rare. Controlled trials and large registries are necessary to provide evidence for future recommendations.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lueker, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sultan, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Plenge, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED van den Bruck, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heeger, C. -H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mischke, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tilz, R. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vollmann, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Noelker, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaeffer, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Willems, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-195057
DOI:	10.1007/s00392-017-1178-y
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	107
Number:	3
Page Range:	S. 249 - 259
Date:	2018
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ATRIAL TACHYARRHYTHMIAS; EXTERNAL CARDIOVERSION; FIBRILLATION; EFFICACY; ARRHYTHMIAS; PREVENTION; LONGEVITY; SAFETY; SHOCK Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19505