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January 1, 2002EP Europace

What is the optimal electrode configuration for atrial defibrillators in man?

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Why the study?

Does the right atrial to distal coronary sinus electrode configuration reduce the atrial defibrillation threshold compared to the can to right ventricular and right atrial configuration in patients with drug refractory persistent AF?

Population

11 patients with drug refractory persistent atrial fibrillation, 73% male, mean age 60.9, undergoing…

Comparison

Right atrial to distal coronary sinus electrode… vs Defibrillator can to right ventricular and right…

Design

RCT, randomized sequence

Follow-up

3 months

Authors

AMAndrew R.J. Mitchell

Discussion

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Overview

RA-CS configuration lowers atrial DFT in persistent AF; supports preferential device lead placement and extends configuration optimization trials.

Structured PICO

Does the right atrial to distal coronary sinus electrode configuration reduce the atrial defibrillation threshold compared to the can to right ventricular and right atrial configuration in patients with drug refractory persistent AF?

P
Population
11 patients with drug refractory persistent atrial fibrillation (AF), 73% male, mean age 60.9 (range 38 to 83), undergoing implantation of a Medtronic Jewel AF dual chamber defibrillator (model 7250).
I
Intervention
Right atrial to distal coronary sinus electrode configuration (RA > CS) for atrial defibrillation
C
Comparator
Defibrillator can to right ventricular and right atrial electrodes configuration (CAN > RV + RA)
O
Outcome
Atrial defibrillation threshold (DFT)surrogate

The right atrium to coronary sinus electrode configuration significantly reduces the atrial defibrillation threshold compared to the can to right ventricular and right atrial configuration in patients with persistent AF.

Cite This Study

Andrew R.J. Mitchell (2002) studied this question.

synapsesocial.com/papers/6a97179931394ac286fbebb9https://doi.org/10.1053/eupc.2001.0207
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Implantable Atrial Defibrillators1995 · 31 citations
  2. 2Right Atrial Septal Electrode for Reducing the Atrial Defibrillation Threshold2001 · 9 citations
  3. 3Atrial defibrillation threshold as a novel predictor of clinical outcome of catheter ablation for persistent atrial fibrillation2010 · 19 citations
  4. 4Initial Clinical Experience with an Implantable Human Atrial Defibrillator1997 · 85 citations
  5. 5Optimization of Atrial Defibrillation with a Dual‐Coil, Active Pectoral Lead System2004 · 7 citations