Abstract
Atrial tachyarrhythmias significantly reduce quality of life in a surprisingly large number of patients. The safe and effective treatment of atrial tachyarrhythmias is being intensively studied. Internal electrical cardioversion of atrial fibrillation has been shown to be an effective non-pharmacological treatment option. Cardioversion therapy has been applied in the absence of a clear understanding of the mechanisms governing the process. Recent measurements of atrial transmembrane potentials using sophisticated optical mapping techniques reveal that internal cardioversion shocks cause changes in repolarization time that favor annihilation of wave fronts. Thus, mechanisms of atrial cardioversion appear to be similar to ventricular defibrillation. Further studies are needed to determine whether cardioversion mechanisms differ for chronic atrial fibrillation compared to acute atrial fibrillation.
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