Methods of sinus rhythm restoration in patients with persistent and long-standing persistent atrial fibrillation
https://doi.org/10.24884/2078-5658-2025-22-3-100-107
Abstract
The objective was to analyze modern approaches to the use of electrical and pharmacological cardioversion in patients with persistent atrial fibrillation (AF).
Materials and methods. A non-systematic literature review was conducted. Russian publications were searched in the eLibrary database, and international publications were sourced from PubMed and Google Scholar.
Results. Cardioversion in patients with persistent AF employs either electrical cardioversion (ECV) or pharmacological cardioversion with cavutilide. ECV demonstrates high efficacy and a low rate of adverse events. However, its effectiveness depends on patients’ constitutional characteristics. Additionally, ECV requires total intravenous anesthesia, which may lead to sedation-related adverse events. Pharmacological cardioversion with cavutilide shows comparable efficacy to ECV. Studies indicate a favorable safety profile for cavutilide; however, due to the risk of proarrhythmic events, strict adherence to administration protocols and extended post-procedural monitoring in intensive care unit are obligatory.
Conclusion. The choice of the optimal method for restoring sinus rhythm in patients with persistent AF should be individualized.
About the Authors
L. M. Kalmanson
Pavlov University
Russian Federation
Russian Federation
Kalmanson Lev M. - Assistant of Anesthesiology and Intensive Care Department, Head of Anesthesiology and Intensive Care Department № 5 of the Research Clinical Center of Anesthesiology and Intensive Care
6-8, L’va Tolstogo str., Saint Petersburg, 197022
E. I. Barashkova
Pavlov University
Russian Federation
Russian Federation
Barashkova Elizaveta I. - Postgraduate Student of the Department of Faculty Therapy with the Course of Endocrinology and Cardiology with Clinic named after Academician G. F. Lang.
6-8, L’va Tolstogo str., Saint Petersburg, 197022
I. V. Shlyk
Pavlov University
Russian Federation
Russian Federation
Shlyk Irina V. - Dr. of Sci. (Med.), Professor of Anesthesiology and Intensive Care Department, Deputy Head of the Research Clinical Center of Anesthesiology and Intensive Care.
6-8, L’va Tolstogo str., Saint Petersburg, 197022
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Review
For citations:
Kalmanson L.M., Barashkova E.I., Shlyk I.V. Methods of sinus rhythm restoration in patients with persistent and long-standing persistent atrial fibrillation. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2025;22(3):100-107. (In Russ.) https://doi.org/10.24884/2078-5658-2025-22-3-100-107
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