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Implantable atrial defibrillators
1Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
Journal of Cardiovascular Electrophysiology
|August 1, 1995
Summary
Implantable atrial defibrillators offer a promising nonpharmacologic treatment for atrial fibrillation. Current research indicates feasibility with low energy and minimal damage, suggesting future therapeutic potential.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Limited efficacy of current antiarrhythmic drugs for atrial fibrillation.
- Emergence of nonpharmacologic therapeutic options, including implantable atrial defibrillators.
Purpose of the Study:
- To evaluate the feasibility and safety of internal atrial defibrillation.
- To determine optimal electrode configurations and energy levels for atrial defibrillation.
Main Methods:
- Utilized large surface area catheters in the right atrium and coronary sinus.
- Employed biphasic shock waveforms for internal atrial defibrillation.
- Assessed pathological damage and potential for ventricular arrhythmias post-shock.
Main Results:
- Atrial defibrillation achieved with < 2 J using optimal electrode configuration and biphasic waveform.
- Shocks < 5 J showed no significant pathological damage to atria or coronary sinus.
- Preliminary data suggest safety of synchronized shocks and good tolerance at < 1.5 J.
Conclusions:
- Internal atrial defibrillation is feasible with low energies and minimal damage.
- Further research is needed to confirm safety regarding ventricular arrhythmias and improve patient tolerance.
- Implantable atrial defibrillators show potential as an acceptable therapy for symptomatic, paroxysmal atrial fibrillation.