Document Detail


What is the optimal electrode configuration for atrial defibrillators in man?
MedLine Citation:
PMID:  11858153     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To compare the atrial defibrillation threshold (DFT) for two electrode configurations in patients with drug refractory persistent atrial fibrillation (AF). METHODS AND RESULTS: 11 patients, 73% male, mean age 60.9 (range 38 to 83), underwent implantation of a Medtronic Jewel AF dual chamber defibrillator (model 7250). A step-up atrial DFT was performed in a randomized sequence for two electrode configurations: (1) Right atrial to distal coronary sinus electrode (RA > CS) and (2) defibrillator can to right ventricular and right atrial electrodes (CAN > RV + RA). The RA > CS configuration restored SR in 10 patients (91%). The CAN > RA + RV configuration restored SR in four patients (36%). The mean atrial DFT was significantly lower for the RA > CS than CAN > RA + RV configuration (10 +/- 7 Joules vs 25 +/- 6 Joules), P < 0.01. At 3 months post implantation, AF was reinduced and the protocol was repeated for the optimal electrode configuration. There was no significant difference in the atrial DFT compared with that at implant. CONCLUSION: The right atrium to coronary sinus electrode configuration significantly reduces the atrial DFT. The atrial DFT also remains stable at 3 months post-implantation. Patients with persistent AF undergoing insertion of an atrial defibrillator should have a coronary sinus electrode implanted.
Authors:
A R J Mitchell; P A R Spurrell; K Kamalvand; M Higson; R Shanmuganathan; N R Patel; N Sulke
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  4     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-02-15     Completed Date:  2002-07-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  41-4     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Eastbourne General Hospital, UK. mitcharj@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Atrial Fibrillation / physiopathology*,  therapy*
Defibrillators, Implantable*
Differential Threshold / physiology*
Equipment Design*
Female
Follow-Up Studies
Heart Atria / physiopathology
Heart Conduction System / physiopathology
Humans
Male
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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