Intravenous sotalol decreases transthoracic cardioversion energy requirement for chronic atrial fibrillation in humans: assessment of the electrophysiological effects by biatrial basket electrodes
Ling-Ping Lai, MD, PhDa,
Jiunn-Lee Lin, MDa,
Wen-Pin Lien, MD, FACCa,
Yung-Zu Tseng, MDa and
Shoei K. Stephen Huang, MD, FACCa
a Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Figure 1 Right anterior oblique 45° and left anterior oblique 45° fluoroscopic projections during the biatrial basket study. Each basket electrode has eight splines with eight electrodes (four bipoles) on each spline. The basket electrode was positioned in the left atrium using the transseptal puncture technique. The spline with a mark at the distal third was designated as spline A, with a mark at the middle third as spline B and distal third spline C. The splines next to spline C were designated splines D, E, F, G and H serially. LAO = left anterior oblique; RAO = right anterior oblique.
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Figure 2 Atrial electrograms recorded before (A, B) and after sotalol infusion (C, D) using two basket electrodes in the RA and LA, respectively. Recordings at A4 and B4 of the RA and at B2, B3 and B4 of the LA were excluded from analysis because the atrial electrograms were too small. These areas might represent areas facing the mitral and tricuspid valve opening, and only ventricular electrograms were recorded. At baseline, the A-A intervals were shorter in the LA (157 ms) than in the RA (182 ms). Sotalol infusion caused a prolongation of the A-A intervals in both atria while the prolongation was larger in the RA (182 to 215 ms) than in the LA (157 to 174 ms). LA = left atrium; RA = right atrium.
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