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  • Erica S. Zado
    Correspondence
    Address reprint requests and correspondence: Ms Erica S. Zado, Section of Cardiac Electrophysiology, Cardiovascular Division, Hospital of the University of Pennsylvania, Founders 9, 3400 Spruce St, Philadelphia, PA 19104.
    Affiliations
    Section of Cardiac Electrophysiology, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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      In this single-center retrospective study, El-Am et al (J Am Coll Cardiol 2019;79:589, PMID 30732713) sought to assess procedural outcomes related to direct current cardioversion (CV) in patients with cardiac amyloidosis (CA). In addition to atrial arrhythmias such as atrial fibrillation (AF), atrial flutter (AFL), and atrial tachycardia (AT), patients with CA are predisposed to conduction disease, heart failure, intracardiac thrombi, and sudden death. All patients with CA referred for CV over a 12-year period were included and matched in a 2:1 ratio for type of arrhythmia (AF, AFL, or AT), age, sex, and date of CV (within 3 months) to controls for comparison. Success was defined as restoration of sinus rhythm (SR) with CV and maintenance while in the recovery unit, and failure was lack of restoration of SR or recurrence while still in the recovery unit. All patients were on therapeutic anticoagulation at the time of CV, and transesophageal echocardiography (TEE) was performed before CV at the discretion of the referring provider.
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