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Article: Atrioverter: An implantable device for the treatment of atrial fibrillation

TitleAtrioverter: An implantable device for the treatment of atrial fibrillation
Authors
KeywordsAtrial defibrillation
Atrial fibrillation
Atrium
Issue Date1998
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://circ.ahajournals.org
Citation
Circulation, 1998, v. 98 n. 16, p. 1651-1656 How to Cite?
AbstractBackground - 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.
Persistent Identifierhttp://hdl.handle.net/10722/49084
ISSN
2015 Impact Factor: 17.047
2015 SCImago Journal Rankings: 7.853
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWellens, HJJen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorLüderitz, Ben_HK
dc.contributor.authorAkhtar, Men_HK
dc.contributor.authorWaldo, ALen_HK
dc.contributor.authorCamm, AJen_HK
dc.contributor.authorTimmermans, Cen_HK
dc.contributor.authorTse, HFen_HK
dc.contributor.authorJung, Wen_HK
dc.contributor.authorJordaens, Len_HK
dc.contributor.authorAyers, Gen_HK
dc.date.accessioned2008-06-12T06:34:04Z-
dc.date.available2008-06-12T06:34:04Z-
dc.date.issued1998en_HK
dc.identifier.citationCirculation, 1998, v. 98 n. 16, p. 1651-1656en_HK
dc.identifier.issn0009-7322en_HK
dc.identifier.urihttp://hdl.handle.net/10722/49084-
dc.description.abstractBackground - 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.en_HK
dc.format.extent418 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://circ.ahajournals.orgen_HK
dc.relation.ispartofCirculationen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectAtrial defibrillationen_HK
dc.subjectAtrial fibrillationen_HK
dc.subjectAtriumen_HK
dc.titleAtrioverter: An implantable device for the treatment of atrial fibrillationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0009-7322&volume=98&issue=16&spage=1651&epage=1656&date=1998&atitle=Atrioverter:+an+implantable+device+for+the+tratment+of+atrial+fibrillationen_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.pmid9778331-
dc.identifier.scopuseid_2-s2.0-7844219853en_HK
dc.identifier.hkuros39283-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-7844219853&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume98en_HK
dc.identifier.issue16en_HK
dc.identifier.spage1651en_HK
dc.identifier.epage1656en_HK
dc.identifier.isiWOS:000076456100011-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWellens, HJJ=35395866600en_HK
dc.identifier.scopusauthoridLau, CP=35275317200en_HK
dc.identifier.scopusauthoridLüderitz, B=7202700926en_HK
dc.identifier.scopusauthoridAkhtar, M=7202577176en_HK
dc.identifier.scopusauthoridWaldo, AL=7102082668en_HK
dc.identifier.scopusauthoridCamm, AJ=7202602504en_HK
dc.identifier.scopusauthoridTimmermans, C=7006153844en_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridJung, W=7201622218en_HK
dc.identifier.scopusauthoridJordaens, L=15059095600en_HK
dc.identifier.scopusauthoridAyers, G=7102015157en_HK

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