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Related Experiment Videos

Implantable atrial defibrillators

R E Hillsley1, J M Wharton

  • 1Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.

Journal of Cardiovascular Electrophysiology
|August 1, 1995
PubMed
Summary
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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.

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  • 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.