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Atrioverter: an implantable device for the treatment of atrial fibrillation

(1998) CIRCULATION. 98(16). p.1651-1656
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Abstract
Background: 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 less than or equal to 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.
Keywords
ATRIOVENTRICULAR-CONDUCTION, ENERGY INTRACARDIAC CARDIOVERSION, INTERNAL CARDIOVERSION, DEFIBRILLATION, EFFICACY, SAFETY, TOLERABILITY, SHEEP, ABLATION, THERAPY, atrial fibrillation, arrhythmia, defibrillator

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Citation

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Chicago
Wellens, Hein JJ, Chu-Pak Lau, Bernd Luderitz, Masood Akhtar, Albert Waldo, A John Camm, Carl Timmermans, et al. 1998. “Atrioverter: An Implantable Device for the Treatment of Atrial Fibrillation.” Circulation 98 (16): 1651–1656.
APA
Wellens, H. J., Lau, C.-P., Luderitz, B., Akhtar, M., Waldo, A., Camm, A. J., Timmermans, C., et al. (1998). Atrioverter: an implantable device for the treatment of atrial fibrillation. CIRCULATION, 98(16), 1651–1656.
Vancouver
1.
Wellens HJ, Lau C-P, Luderitz B, Akhtar M, Waldo A, Camm AJ, et al. Atrioverter: an implantable device for the treatment of atrial fibrillation. CIRCULATION. 1998;98(16):1651–6.
MLA
Wellens, Hein JJ et al. “Atrioverter: An Implantable Device for the Treatment of Atrial Fibrillation.” CIRCULATION 98.16 (1998): 1651–1656. Print.
@article{8048782,
  abstract     = {Background: 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 less than or equal to 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.},
  author       = {Wellens, Hein JJ and Lau, Chu-Pak and Luderitz, Bernd and Akhtar, Masood and Waldo, Albert  and Camm, A John and Timmermans, Carl and Tse, Hung-Fat and Jung, Werner and Jordaens, Luc and Ayers, Greg},
  issn         = {0009-7322},
  journal      = {CIRCULATION},
  keywords     = {ATRIOVENTRICULAR-CONDUCTION,ENERGY INTRACARDIAC CARDIOVERSION,INTERNAL CARDIOVERSION,DEFIBRILLATION,EFFICACY,SAFETY,TOLERABILITY,SHEEP,ABLATION,THERAPY,atrial fibrillation,arrhythmia,defibrillator},
  language     = {eng},
  number       = {16},
  pages        = {1651--1656},
  title        = {Atrioverter: an implantable device for the treatment of atrial fibrillation},
  volume       = {98},
  year         = {1998},
}

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