E-4 | Do Obese Patients With Atrial Fibrillation Require More Joules for Direct Current Cardioversion to Restore Sinus Rhythm? Article Swipe
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· 2023
· Open Access
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· DOI: https://doi.org/10.1016/j.jscai.2023.100912
· OA: W4377107898
Antiarrhythmic drugs, direct current (DC) cardioversion, and ablation remain standard treatment strategies to restore sinus rhythm in patients with atrial fibrillation. Data is limited to predict if patients with higher body mass index require more joules to restore sinus rhythm with DC cardioversion. We studied 67 consecutive patients with atrial fibrillation successfully cardioverted to sinus rhythm with synchronized DC cardioversion. Patients were stratified into two groups: Group 1 with a BMI of ≤ 30. Group 2 with a BMI of >30. Patients underwent a transesophageal echocardiogram to ensure the absence of clots, following which patients were cardioverted to sinus rhythm with direct current cardioversion 100 joules, 200 joules, 360 joules biphasic to restore sinus rhythm in an escalating manner. Clinical characteristics were comparable in the two groups. Sleep apnea was more prevalent in the obese group. The use of antiarrhythmic drugs was similar in the two groups, 62% versus 47% (p-value 0.1). Obese patients were young and required more joules 208 versus 163 joules to restore sinus rhythm (p-value 0.02). Obese patients with atrial fibrillation require more joules for electrical synchronized cardioversion to restore sinus rhythm.
