Intracardiac Cardioversion for Ablation of the Atrioventricular Conduction System in Patients with Drug Resistant Atrial Flutter

The technique of intracardiac cardioversion for the ablation of the atrioventricular conduction system was used in three male patients (65, 53 and 57 years of age) with atrial flutter unresponsive to medical management. In the first patient a DC current of 80 J was applied while the other patients required 300 and 400 J respectively. In the first patient a transient third degree AVblock was induced enabling the ventricular rate to be easily controlled with drugs. This patient died 5 months later of resistant congestive heart failure. Autopsy revealed no gross evidence of myocardial damage in the tricuspid valve area or in the interventricular septum. In the other two patients a permanent th…