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Article: Effect of the implantable atrial defibrillator on the natural history of atrial fibrillation

TitleEffect of the implantable atrial defibrillator on the natural history of atrial fibrillation
Authors
Issue Date1999
PublisherWiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873
Citation
Journal Of Cardiovascular Electrophysiology, 1999, v. 10 n. 9, p. 1200-1209 How to Cite?
AbstractIntroduction: The purpose of our study was to evaluate the effect of repeated cardioversion with an implantable atrial defibrillator on the clinical outcome of patients with atrial fibrillation. Methods and Results: The effects of the implantable atrial defibrillator on the total duration of atrial fibrillation, number of atrial fibrillation recurrences, and left atrial size were evaluated prospectively in 16 patients with atrial fibrillation (13 men and 3 women; mean age 58 ± 11 years). Seven patients had no cardiovascular disease, 5 patients had hypertension, 3 patients had coronary heart disease, and 1 patient had congenital heart disease. Eight patients had paroxysmal atrial fibrillation for a mean duration of 80 ± 61 months, and eight patients had persistent atrial fibrillation for a mean duration of 68 ± 119 months. Except for one patient who received digoxin throughout the study, all patients received the same Class I or III antiarrhythmic agent throughout the study. The implantable atrial defibrillator successfully converted 50 (93%) of 54 spontaneous episodes of atrial fibrillation in 12 patients. During the initial 3 months of clinical follow-up, the atrial defibrillator documented 261 ± 270 hours of atrial fibrillation compared with 126 ± 172 hours (P = 0.01) during the subsequent 3 months. The left atrial size decreased from 4.4 ± 0.7 cm at the time of atrial defibrillator implantation to 4.1 ± 0.6 cm (P = 0.02) 6 months later. The number of atrial fibrillation recurrences did not change. These findings were observed in the absence of changes in drug therapy. No complications were observed. Conclusion: Restoration and maintenance of sinus rhythm in patients with atrial fibrillation by repeated cardioversion with an implantable atrial defibrillator was associated with a reduction in the total arrhythmia duration and a reduction in left atrial size. These results suggest that maintenance of sinus rhythm with the atrial defibrillator may reverse the remodeling process associated with atrial fibrillation.
Persistent Identifierhttp://hdl.handle.net/10722/76376
ISSN
2015 Impact Factor: 3.097
2015 SCImago Journal Rankings: 1.863
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTse, HFen_HK
dc.contributor.authorLau, CPen_HK
dc.contributor.authorYu, CMen_HK
dc.contributor.authorLee, KLFen_HK
dc.contributor.authorMichaud, GFen_HK
dc.contributor.authorKnight, BPen_HK
dc.contributor.authorMorady, Fen_HK
dc.contributor.authorStrickberger, SAen_HK
dc.date.accessioned2010-09-06T07:20:34Z-
dc.date.available2010-09-06T07:20:34Z-
dc.date.issued1999en_HK
dc.identifier.citationJournal Of Cardiovascular Electrophysiology, 1999, v. 10 n. 9, p. 1200-1209en_HK
dc.identifier.issn1045-3873en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76376-
dc.description.abstractIntroduction: The purpose of our study was to evaluate the effect of repeated cardioversion with an implantable atrial defibrillator on the clinical outcome of patients with atrial fibrillation. Methods and Results: The effects of the implantable atrial defibrillator on the total duration of atrial fibrillation, number of atrial fibrillation recurrences, and left atrial size were evaluated prospectively in 16 patients with atrial fibrillation (13 men and 3 women; mean age 58 ± 11 years). Seven patients had no cardiovascular disease, 5 patients had hypertension, 3 patients had coronary heart disease, and 1 patient had congenital heart disease. Eight patients had paroxysmal atrial fibrillation for a mean duration of 80 ± 61 months, and eight patients had persistent atrial fibrillation for a mean duration of 68 ± 119 months. Except for one patient who received digoxin throughout the study, all patients received the same Class I or III antiarrhythmic agent throughout the study. The implantable atrial defibrillator successfully converted 50 (93%) of 54 spontaneous episodes of atrial fibrillation in 12 patients. During the initial 3 months of clinical follow-up, the atrial defibrillator documented 261 ± 270 hours of atrial fibrillation compared with 126 ± 172 hours (P = 0.01) during the subsequent 3 months. The left atrial size decreased from 4.4 ± 0.7 cm at the time of atrial defibrillator implantation to 4.1 ± 0.6 cm (P = 0.02) 6 months later. The number of atrial fibrillation recurrences did not change. These findings were observed in the absence of changes in drug therapy. No complications were observed. Conclusion: Restoration and maintenance of sinus rhythm in patients with atrial fibrillation by repeated cardioversion with an implantable atrial defibrillator was associated with a reduction in the total arrhythmia duration and a reduction in left atrial size. These results suggest that maintenance of sinus rhythm with the atrial defibrillator may reverse the remodeling process associated with atrial fibrillation.en_HK
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873en_HK
dc.relation.ispartofJournal of Cardiovascular Electrophysiologyen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAtrial Fibrillation - physiopathology - therapyen_HK
dc.subject.meshAtrial Function, Leften_HK
dc.subject.meshDefibrillators, Implantableen_HK
dc.subject.meshElectrocardiographyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleEffect of the implantable atrial defibrillator on the natural history of atrial fibrillationen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1045-3873&volume=10&spage=1200&epage=1209&date=1999&atitle=Effect+of+the+implantable+atrial+defibrillator+on+the+natural+history+of+atrial+fibrillationen_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid10517652-
dc.identifier.scopuseid_2-s2.0-0032861987en_HK
dc.identifier.hkuros49716en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0032861987&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume10en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1200en_HK
dc.identifier.epage1209en_HK
dc.identifier.isiWOS:000082691500005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.scopusauthoridYu, CM=7404976646en_HK
dc.identifier.scopusauthoridLee, KLF=7501505962en_HK
dc.identifier.scopusauthoridMichaud, GF=7006729860en_HK
dc.identifier.scopusauthoridKnight, BP=7201940628en_HK
dc.identifier.scopusauthoridMorady, F=35431764400en_HK
dc.identifier.scopusauthoridStrickberger, SA=7005045293en_HK

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