{"_buckets": {"deposit": "e000514b-0ff1-41b8-8602-43610290b862"}, "_deposit": {"id": "4378", "owners": [], "pid": {"revision_id": 0, "type": "depid", "value": "4378"}, "status": "published"}, "_oai": {"id": "oai:soar-ir.repo.nii.ac.jp:00004378"}, "item_6_alternative_title_1": {"attribute_name": "\u305d\u306e\u4ed6\uff08\u5225\u8a00\u8a9e\u7b49\uff09\u306e\u30bf\u30a4\u30c8\u30eb", "attribute_value_mlt": [{"subitem_alternative_title": "Management of Atrial Fibrillation in the Outpatient Clinic : Restoration and Maintenance of Sinus Rhythm"}]}, "item_6_biblio_info_6": {"attribute_name": "\u66f8\u8a8c\u60c5\u5831", "attribute_value_mlt": [{"bibliographicIssueDates": {"bibliographicIssueDate": "1999-08-10", "bibliographicIssueDateType": "Issued"}, "bibliographicIssueNumber": "4", "bibliographicPageEnd": "296", "bibliographicPageStart": "287", "bibliographicVolumeNumber": "47", "bibliographic_titles": [{"bibliographic_title": "\u4fe1\u5dde\u533b\u5b66\u96d1\u8a8c"}]}]}, "item_6_description_20": {"attribute_name": "\u6284\u9332", "attribute_value_mlt": [{"subitem_description": "High-energy direct current cardioversion (DC;up to 360J)and subsequent intensive antiarrhythmic agent administration (including class Ic or class \u2162 drugs)were performed in patients with chronic atrial fibrillation (Af)in an outpatient clinic to restore and maintain sinus rhythm.Cases of left ventricular dysfunction,mitral valvular disease, or hyperthyroidism were excluded. DC was performed 38 times in 23 patients. No thromboembolic complications were observed with preceding anticoagulation. A total of 31 shocks resulted in conversion to sinus rhythm (81.6% of all procedures) in 20 cases.During the mean follow-up period of 602 days,13 patients maintained sinus rhythm (56.5% of total cases;65.0% of defibrillated cases.). Final antiarrhythmic agents were as follows:class Ia in 2 cases (15.4%),class Ic in  3 (23.1%),class \u2162 in 4 (30.7%),class \u2162 \uff0b\u03b2-blocker in 3 (23.1%), none in 1 (7.7%).In 5 cases,class Ia drugs were changed to class \u2162 agents due to recurrent Af. No proarryhthmia was observed. Anticoagulation with warfarin was discontinued in 9 patients (69.2%)who maintained sinus rhythm. Our method is considered safe and effective. 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