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Atrial Fibrillation: The Role of Atrial Defibrillation

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Abstract

Dual defibrillator implantation represents an emerging option to treat patients with drug refractory atrial fibrillation. Atrial antitachycardia pacing and cardioversion have been demonstrated to be highly effective in treating spontaneous tachyarrhythmias and may reduce atrial fibrillation burden by preventing atrial remodeling. Device implantation has been associated to improved quality of life and reduced hospitalization rate. Patient selection and tailored device programming are critical as regard to clinical outcome. Individual psychological profile analysis as well as underlying heart disease and atrial fibrillation clinical patterns represent the main drivers for the right strategy. Controlled studies are needed in order to define the subset of patients who can benefit more from device implantation.

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References

  1. Wolf PA, Mitchell JB, Baker CS, Kannel WB, D'Agostino RB. Impact of atrial fibrillation on mortality, stroke and medical costs. Arch Intern Med 1998;158:229–234.

    Google Scholar 

  2. Kannel WB, Abbot RD, Savage DD, McNamara PM. Epidemiologic features of chronic atrial fibrillation. New Engl J Med 1982;306:1018–1022.

    Google Scholar 

  3. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: The Framingham study. Stroke 1991;22:983–988.

    Google Scholar 

  4. Hamer ME, Blumenthal JA, McCarthy EA, Phillips BG, Pritchett ELC. Quality of life assessment in patients with paroxysmal atrial fibrillation or paroxysmal supraventricular tachycardia. Am J Cardiol 1994;74:826–829.

    Google Scholar 

  5. Suttorp MJ, Kingma JH, Koomen EM, van't Hof A, Tijssen JG, Li. Recurrence of paroxysmal atrial fibrillation or flutter after successful cardioversion in patients with normal left ventricle function. Am J Cardiol 1993;71:710–713.

    Google Scholar 

  6. Schoels W, Swerdlow CD, Jung W, Stein KM, Seidl KH, Haffajee CJ, for the Worldwide Jewel AF Investigators. Worldwide clinical experience with a new dual chamber implantable cardioverter defibrillator system. J Cardiovasc Electrophysiol 2001;12:521–528.

    Google Scholar 

  7. Ricci R, Pignalberi C, Disertori M, Capucci A, Padeletti L, Botto G, Toscano S, Miraglia F, Grammatico A, Santini M. Efficacy of a dual chamber defibrillator with atrial antitachycardia functions in treating spontaneous atrial tachyarrhythmias in patients with life-threatening ventricular tachyarrhythmias. Eur Heart J 2002;23:1471–1479.

    Google Scholar 

  8. Adler SW, Wolpert C, Warman EN, Musley SK, Koehler JL, Euler DE for the Worldwide Jewel AF Investigators. Efficacy of pacing therapies for treating atrial tachyarrhythmias in patients with ventricular arrhythmias receiving a dual-chamber implantable cardioverter defibrillator. Circulation 2001;104:887–892.

    Google Scholar 

  9. Friedman PA, Dijkman B, Warman EN, Xia HA, Mehra R, Stanton MS, Hamill SC, for theWorldwide Jewel AF Investigators. Atrial therapies reduce atrial arrhythmia burden in defibrillator patients. Circulation 2001;104:1023–1028.

    Google Scholar 

  10. Gold MR, Sulke N, Schwartzman DS, Mehra R, Euler DE, for the Worldwide Jewel AF-Only Investigators. Clinical experience with a dual chamber implantable cardioverter defibrillator to treat atrial tachyarrhythmias. J Cardiovasc Electrophysiol 2001;12:1247–1253.

    Google Scholar 

  11. Ricci R, Quesada A, Pignalberi C, Disertori M, Capucci A, Raviele A, Grovale N, Santini M. Dual defibrillator improves quality of life and decreases resource utilization in patients with drug refractory atrial fibrillation. (Abstract) XXIV Congress of The European Society of Cardiology, Berlin, August 31–September 4, 2002. Eur Heart J 2002;23 (Suppl):659.

    Google Scholar 

  12. Ricci R, Quesada A, Roda J, Disertori M, Capucci A, Raviele A, Grovale N, Santini M. Early atrial shock delivering reduces atrial fibrillation burden and hospitalizations in patients wearing a dual defibrillator. (Abstract) XXIV Congress of The European Society of Cardiology, Berlin, August 31–September 4, 2002. Eur Heart J 2002;23(Suppl):659.

    Google Scholar 

  13. Wijffels MC, Kirchhof CJ, Dorland R, Allessie MA. Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation 1995;92:1954–1968.

    Google Scholar 

  14. Timmermans C, Levy S, Ayers GM, for the Metrix Investigators. Spontaneous episodes of atrial fibrillation after implantation of the Metrix atrioverter: Observations on treated and nontreated episodes. J Am Coll Cardiol 2000;35:1428–1433.

    Google Scholar 

  15. Tse HF, Lau CP, Yu CM, Lee KL, Michaud GF, Knight BP, Morady F, Strickberger SA. Effect of the implantable atrial defibrillator on the natural history of atrial fibrillation. J Cardiovasc Electrophysiol 1999;10:1200–1209.

    Google Scholar 

  16. Mitchell ARJ, Spurrell PAR, Ahmet H, Higson M, Sulke N. Reversal of tachycardiomyopathy by the atrial defibrillator. A case report. The European Journal of Heart Failure 2002;4:485–488.

    Google Scholar 

  17. Jung W, Luderitz B. Quality of life in patients with atrial fibrillation. J Cardiovasc Electrophysiol 1998;9(Suppl 8):S177–S186.

    Google Scholar 

  18. Chevalier P, Verrier P, Kirkorian G, Touboul P, Cottraux J. Improved appraisal of the quality of life in patients with automatic implantable cardioverter defibrillator: A psychometric study. Psychother Psychosom 1996;65:49–56.

    Google Scholar 

  19. Herrmann C, vonzurMuhen F, Schaumann A, Buss U, Kemper S, Wantzen C, Gonska BD. Standardized assessment of psychological well-being and quality-of-life in patients with implanted defibrillators. Pacing Clin Electrophysiol 1997;20:95–103.

    Google Scholar 

  20. Santini M, Pandozi C, Altamura G, Gentilucci G, Villani M, Scianaro MC, Castro A, Ammirati F, Magris B. Single shock endocavitary low energy intracardiac cardioversion of chronic atrial fibrillation. J Interv Card Electrophysiol 1999;3:45–51.

    Google Scholar 

  21. Steinhaus DM, Cardinal DS, Mongeon L, Musley SK, Foley L, Corrigan S. Internal defibrillation: Pain perception of low energy shocks. Pacing Clin Electrophysiol 2002; 25:1090–1093.

    Google Scholar 

  22. Gallagher RD, McKinley S, Mangan B, Pelletier D, Squire J, Mitten-Lewis S. The impact of the implantable cardioverter defibrillator on quality of life. Am J Crit Care 1997;6:16–24.

    Google Scholar 

  23. Wellens HJJ, Lau CP, Luderitz B, Akhtar M, Waldo AL, Camm AJ, Timmermans C, Tse HF, Jung W, Jordaens L, Ayers G. Atrioverter: An implantable device for the treatment of atrial fibrillation. Circulation 1998;98:1651–1656.

    Google Scholar 

  24. Cooper JM, Katcher MS, Orlov MV. Current concepts: Implantable devices for the treatment of atrial fibrillation. N Engl J Med 2002;346:2062–2068.

    Google Scholar 

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Correspondence to Massimo Santini.

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Santini, M., Ricci, R. Atrial Fibrillation: The Role of Atrial Defibrillation. J Interv Card Electrophysiol 9, 229–233 (2003). https://doi.org/10.1023/A:1026244726090

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