CARDIOVERSION AS AN ADJUNCT TO CARDIAC SURGERY.

Direct current cardioversion has been used in 87 patients either before or after cardiac surgery at the University of Minnesota Medical Center. Forty per cent of the preoperative patients and 48 per cent of the postoperative patients were restored to a sinus rhythm for more than 1 month. In preoperative patients, restoration of a sinus rhythm improved the cardiac reserve and facilitated preparation of poor-risk patients for surgery. It also aided in differentiating functional from organic tricuspid valvular disease. In the postoperative patient, conversion to a sinus rhythm appeared to improve cardiac function. The incidence of successful cardioversion was 66 per cent if attempted 6 or more months after surgery, whereas it was only 33 per cent when carried out earlier. We now consider d.c. cardioversion the method of choice in the management of atrial flutter in the postoperative period and have been successful in converting 90 per cent of patients with this arrhythmia. Anticoagulant therapy before cardioversion does not appear to protect against thromboembolic complications after conversion, Procaineamide and quinidine sulfate appear to be equally effective as anti-arrhythmia drugs when used in association with d.c. cardioversion. [ABSTRACT FROM AUTHOR]