Intra-atrial defibrillation for atrial fibrillation: animal data.
Animal research in the area of atrial defibrillation has helped to bring about a greater understanding of the mechanisms and influencing factors of atrial defibrillation. Increased clinical interest in atrial tachyarrhythmias during the 1980s led to more intensive animal research in this area, in which concepts of intra-atrial cardioversion was only first described in 1974. Initially, the concept of one intracardiac catheter in conjunction with a subcutaneous electrode was evaluated. Further studies involved alternative waveforms, shock durations, electrode materials, and lead configurations to improve the percentage of successful cardioversions while reducing energy requirements. The results from ventricular defibrillation, in which the need for a homogenous field through the majority of fibrillating mass had been established, were applied to research for atrial defibrillation as well. An intracardiac vector with electrodes inside the heart was determined to be most efficient. Results concerning the feasibility, efficacy, and safety have been confirmed by clinical data. Further animal studies will help to evaluate new concepts for reducing energy requirements, such as new electrode materials and advanced shock timing. The clinical benefits of basic research in internal cardioversion of atrial fibrillation justifies additional animal research studies.
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I. Medizinische Klinik, Klinikum rechts der Isar, Munich, Germany.
Herrmann
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D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000628:therapy*; D004554:Electric Countershock; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans