After unsuccessful electric electroversion of atrial fibrillationK Magnusson*, T Othman, NA Cicco*, EG Vester* *Department

After unsuccessful electric electroversion of atrial fibrillationK Magnusson*, T Othman, NA Cicco*, EG Vester* *Department of Cardiology, and Department of Internal Medicine, PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20725854 Evangelisches Krankenhaus Duesseldorf, Germany Introduction: Ibutilide, an anti-arrhythmic drug (Vaughn Wiliams Classification Type III) is used to support the Cardioversion (CV) of atrial fibrillation and atrial flutter since some years yet. Under usage of ibutilide lower energy charges for electroversion and higher rates of success have been reported. Methods: In this prospective study all patients with atrial fibrillation received, after unsuccessful synchronized electroversion with increased energy charges till 360 J, 1.0 mg ibutilide within 10 min. After that procedure a new electroversion was performed. The success-rates have been reported. BBI503 cost Results: The procedure was performed in 18 patients with a mean age of 62 ?11.2 (SD) years. At admission the atrial fibrillation was persistent meanly for 333 ?934.1 days (range 1?000 days). The mean size of the left atrium was 48 ?7.4 mm (range 30?0 mm). In four patients a coronary heart disease was diagnosed. In 15 patients a stable sinus-rhythm (SR) could be reported after the ibutilide infusion and further electroversion with 360 J. In two patients SR could be reported after the ibutilide infusion without any further electroversion. In one patient the atrial fibrillation was persistent although he received the therapy with ibutilide. No side-effects, especially no ventricular tachycardia, occurred.Conclusion: In patients with atrial fibrillation and unsuccessful electroversion a new try should be performed after infusion of 1.0 mg ibutilide. Also in patients with chronically atrial fibrillation for years and/or dilated left atrium this procedure is promising a safe and minimally invasive help for a successful electroversion.P145 Acute atrial fibrillation (AAF) in cardiac surgery postoperative period (PP): its influence in mortality, intensive care and hospital length of stay (LOS) and costsFG Aranha, JESS Pinto, RV Gomes, LAA Campos, MAO Fernandes, PMM Nogueira, AGR Carvalho, J Sabino, DJS Filho, HJ Dohmann Hospital Pr?Card co, Surgical Intensive Care Unit (SICU), PROCEP, RJ, Brazil Background: AAF in cardiac surgery postoperative period has been implicated as a complication that leads to longer ICU and hospital stay and to augmented costs. However, it has not been associated with increased mortality rates. Objective: To determine possible correlation between the occurrence of AAF and length of SICU LOS, total hospital LOS, costs and mortality. Patients and methods: Three hundred and fifty adult patients consecutively admitted in the immediately postoperative period were prospectively evaluated between June 2000 and November 2001. Those with previously documented atrial flutter or atrial fibrillation were excluded. Patients were included in Group (G) A when AAF did not occur in the PP and in G B when it occurred. Statistical techniques were: t Student test, Fischer test and linear regression. Results: G A included 263 and G B 87 patients (24.8 ). The hospital mortality shows no statistically significant difference (15 patients in G A [5.7 ] and 6 in G B [6.8 ] — P = 0.7). The mean SICU LOS was significantly higher in G B (4.47 ?6.4 days in G A versus 9.74 ?12.6 days in G B — P < 0.001), as well as the hospital LOS (9.26 ?12.7 days in G A versus 13.69 ?11.4 days in G B -- P < 0.001). Hospital costs were increased in 6.