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Atrioverter: An Implantable Device for the Treatment of Atrial Fibrillation
- Source :
- Circulation, 98(16), 1651-1656. LIPPINCOTT WILLIAMS & WILKINS
- Publication Year :
- 1998
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 1998.
-
Abstract
- Background —During atrial fibrillation, electrophysiological changes occur in atrial tissue that favor the maintenance of the arrhythmia and facilitate recurrence after conversion to sinus rhythm. An implantable defibrillator connected to right atrial and coronary sinus defibrillation leads allows prompt restoration of sinus rhythm by a low-energy shock. The safety and efficacy of this system, called the Atrioverter, were evaluated in a prospective, multicenter study. Methods and Results —The study included 51 patients with recurrent atrial fibrillation who had not responded to antiarrhythmic drugs, were in New York Heart Association Heart failure class I or II, and were at low risk for ventricular arrhythmias. The atrial defibrillation threshold had to be ≤240 V during preimplant testing. Atrial fibrillation detection, R-wave shock synchronization, and defibrillation threshold were tested at implantation and during follow-up. Shock termination of spontaneous episodes of atrial fibrillation was performed under physician observation. Results are given after a minimum of 3 months of follow-up. During a follow-up of 72 to 613 days (mean, 259±138 days), 96% of 227 spontaneous episodes of atrial fibrillation in 41 patients were successfully converted to sinus rhythm by the Atrioverter. In 27% of episodes, several shocks were required because of early recurrence of atrial fibrillation. Shocks did not induce ventricular arrhythmias. Most patients received antiarrhythmic medication during follow-up. In 4 patients, the Atrioverter was removed: in 1 because of infection, in 1 because of cardiac tamponade, and in 1 because of frequent episodes of atrial fibrillation requiring His bundle ablation. Conclusions —With the Atrioverter, prompt and safe restoration of sinus rhythm is possible in patients with recurrent atrial fibrillation.
- Subjects :
- Adult
Male
medicine.medical_specialty
Defibrillation
medicine.medical_treatment
Implantable defibrillator
atrial defibrillation
INTERNAL CARDIOVERSION
THERAPY
Defibrillation threshold
Risk Factors
Physiology (medical)
Internal medicine
Atrial Fibrillation
ABLATION
medicine
Humans
Arrhythmia, Sinus
Sinus rhythm
cardiovascular diseases
Atrium (heart)
Coronary sinus
Aged
Venous Thrombosis
ENERGY INTRACARDIAC CARDIOVERSION
business.industry
DEFIBRILLATION
Atrial fibrillation
Middle Aged
ATRIOVENTRICULAR-CONDUCTION
EFFICACY
medicine.disease
Defibrillators, Implantable
Treatment Outcome
medicine.anatomical_structure
SHEEP
SAFETY
Anesthesia
Heart failure
cardiovascular system
Cardiology
TOLERABILITY
Female
Cardiology and Cardiovascular Medicine
business
atrium
Subjects
Details
- ISSN :
- 15244539 and 00097322
- Volume :
- 98
- Database :
- OpenAIRE
- Journal :
- Circulation
- Accession number :
- edsair.doi.dedup.....a82bc440534cc7cde4da8dfe02d38331