title: Dual defibrillator improves quality of life and decreases hospitalizations in patients with drug refractory atrial fibrillation.
abstract: OBJECTIVE
  to evaluate the impact of dual defibrillator implantation on quality of life and resource utilization in patients with drug refractory atrial fibrillation (AF) without prior ventricular arrhythmias.
  
  
  METHODS
  Forty patients (28 M, mean age 64 +/- 10) received a dual defibrillator Medtronic 7250. AF was persistent in 60% and paroxysmal in 40%.
  
  
  RESULTS
  The follow-up lasted 15 +/- 4 months (range 12-30). Eighty-five percent of patients had atrial tachyarrhythmia recurrences. Among 1366 treated episodes, overall success rate was 60.1% for antitachy pacing and 88.2% for atrial shock. Within one year after implant, arrhythmia related hospitalization number decreased from 1.5 +/- 2.0 to 0.4 +/- 0.8 ( p < 0.01) and 77% of patients were free from hospitalization. As regard to quality of life, Symptom Checklist/Frequency and Severity Scale improved after implant for all items and SF-36 questionnaire showed significant improvements in physical activities because of health problems and social activities. The patients assigned to early delivery of atrial shock after AF onset, when compared with the patients who did not accept atrial shock, showed a significant reduction of AF burden, a higher reduction of hospitalization number and a greater improvement of quality of life.
  
  
  CONCLUSIONS
  Dual defibrillator improved quality of life and decreased resource utilization in patients with drug refractory AF. Early delivering of atrial shock seems to be the most effective option.
authors.affiliation: San Filippo Neri Hospital in Rome, Italy. renatopietroricci@tin.it
authors.forename: Renato
authors.initials: R
authors.lastname: Ricci
authors.forename: Aurelio
authors.initials: A
authors.lastname: Quesada
authors.forename: Carlo
authors.initials: C
authors.lastname: Pignalberi
authors.forename: Josè
authors.initials: J
authors.lastname: Roda
authors.forename: Marcello
authors.initials: M
authors.lastname: Disertori
authors.forename: Alessandro
authors.initials: A
authors.lastname: Capucci
authors.forename: Antonio
authors.initials: A
authors.lastname: Raviele
authors.forename: Massimo
authors.initials: M
authors.lastname: Santini
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000628:therapy*; D017147:Defibrillators, Implantable; D004554:Electric Countershock; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012008:Recurrence; D011795:Surveys and Questionnaires; D016896:Treatment Outcome