Results
The baseline clinical characteristics of study patients are shown in Table 1. The mean age of the study cohort was 67 ± 11 years, 55 patients (61%) were male. The mean CHA2DS2VASc was 3.5 ± 1.5. Baseline mean heart rate in AF was 80 ± 20 bpm. In 7 patients (8%), CV was performed due to persistent atrial flutter. Most patients had hypertension 60 (67%) and were likely to receive novel oral anti-coagulants 66 (73%). Amiodarone was the most common antiarrhythmic medication used prior to CV (60 patients, 67%). Despite the fact that the vast majority of patients were on adequate anti-coagulation status, TEE was performed in 63 (70%) patients prior to CV, due to increased stroke risk in this population.
Eleven patients did not convert to SR with the first electrical shock. Reloading of the same anti-arrhythmic medication, as described in the methods section, was performed in them (8 patients with Amiodarone and 3 with Flecainide). Among them, 8 patients (5 Amiodarone, 3 Flecainide) converted to SR with the second ECV. The remaining 3 patients, needed a third ECV with 360 Joules in order to convert to SR.