Prognosis of atrial arrhythmias treated by electrical counter shock therapy. A three-year follow-up.

Since the introduction of closed chest synchronized DC shock treatment for atrial fibrillation by Lown in 1962 (Lown, Amarasingham, and Newman, 1962a; Lown et al., 1962b) many thousands of patients have undergone this treatment. Complications have occurred on occasion. Arrhythmias, some fatal, have been reported by Ross (1964), Morris et al. (1964), Killip (1963), and Turner and Towers (1965). In addition, Lown, et al. (1963), Rabbino, Likoff, and Dreifus (1964), Oram and Davies (1964), and Navab and La Due (1965) reported that arterial emboli might occur. The incidence of myocardial damage has been documented by Sussman, Woldenberg, and Cohen (1964), Turner and Towers (1964), and Resnekov and McDonald (1965, 1967). Pulmonary oedema has been repbrted by Resnekov and McDonald (1965), Paloheimo (1965), and Honey, Nicholls, and Towers (1965); hypotension by Turner and Towers (1965); and the emergence of digitalis toxicity after conversion by Gilbert and Cuddy (1965). However, the over-all incidence of serious side effects or permanent sequelae is very low. Recurrence of the arrhythmia is frequent. In the following paper the results, complications, and follow-up of 149 patients defibrillated between May 1964 and July 1967 are presented.