title: [Atrial defibrillators].
abstract: The promising results achieved with low-energy, internal atrial cardioversion have stimulated the development of an implantable atrial defibrillator. Initial clinical experience with the Metrix system in a group of highly selected patients with refractory atrial fibrillation (AF) suggests that atrial defibrillation can be performed effectively and safely by using a stand-alone device. The extension of this therapy will depend on the results of further prospective studies comparing this new therapeutic option with other new non-pharmacological methods to treat AF. Internal atrial cardioversion is feasible at low energies with current endocardial transvenous lead configurations primarily designed for ventricular defibrillation. As AF is a frequent arrhythmia in implantable cardioverter defibrillator recipients, the capability for atrial defibrillation has recently been incorporated in a newly designed dual chamber defibrillator (Jewel AF system). Initial clinical experience with this device that combines both detection and treatment in the atrium as well as in the ventricle indicates a significant improvement in the management of patients with both supraventricular and ventricular tachyarrhythmias.
authors.affiliation: Medizinische Klinik I Reinhard-Nieter-Krankenhaus Friedrich-Paffrath-Str. 100 26389 Wilhelmshaven.
authors.forename: A
authors.initials: A
authors.lastname: Heisel
authors.forename: J
authors.initials: J
authors.lastname: Jung
authors.forename: A
authors.initials: A
authors.lastname: Buob
authors.forename: S
authors.initials: S
authors.lastname: Siaplaouras
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000628:therapy*; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged