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June 13, 1966

Lack of Effect of Direct-Current Cardioversion on Fibrinolysis

Author Affiliations

From the Cardiovascular Research Laboratory, Maine Medical Center, Portland, Me. Dr. Derman is a research fellow at the Cardiovascular Research Center. Dr. Stinebaugh is a National Institutes of Health postdoctoral research fellow.

JAMA. 1966;196(11):1013. doi:10.1001/jama.1966.03100240147037

As direct-current conversion of cardiac arrhythmias is attaining ever increasing popularity, it is important to establish the effect of this procedure on the blood coagulation. The effect of electro-shock therapy on fibrinolysis1,2 has been studied, but we are not aware of any previous coagulation studies on patients who have undergone closed "cardioversion." In order to evaluate this problem, euglobulin clot lysis3 determinations were done before and after direct-current cardioversion in 12 patients.

Materials and Methods.—  Twelve patients, who received direct-current shocks for the conversion of cardiac arrhythmias were included in this study. In all cases the same apparatus was used to deliver the electrical shock. The capacitor discharge was synchronized with the electrical activity of the heart and programmed to be delivered on the downstroke of the R wave. One electrode was placed over the sternum, and the other in the left midaxillary line. Routinely, 100 watt-seconds of