[Return of sinus rhythm in permanent atrial fibrillation patients at the time of the testing defibrillation during cardioverter-defibrillator implantation].
Among patients, who underwent implantable cardioverter-defibrillator (ICD) implantation procedure, there are some, who have permanent atrial fibrillation (AF). There is a theoretical possibility of return of sinus rhythm at these patients during ventricular defibrillation testing at the time of the ICD implantation procedure. The aim of the study was to attempt to find agents which can promote return of sinus rhythm at the time of the defibrillation testing during ICD implantation.


METHODS
Seventy-two (mean age 65.8 years, 60 men) of the 611 patients (mean age 63.3 years, 501 men) who underwent ICD induction over this period had permanent AF before and at the time of the procedure.


RESULTS
The return of sinus rhythm was observed in 17 patients (Group A, mean age 64.2 years, 14 men) during ICD implantation, at the time of the defibrillation testing. The return of sinus rhythm after ICD intervention could be associated with presence of 2-coil electrode (p < 0.001), with lower left atrial diameter (p < 0.001), with lower NYHA class (p < 0.05) and greater use of antiarrhythmic drugs (p < 0.025).


CONCLUSIONS
Atrial fibrillation was present in 11.7% of 611 ICD patients. We observed the return of sinus rhythm after ICD intervention in 2.7% persons. The return of sinus rhythm could be associated with presence of 2-coil electrode, lower left atrial diameter, lower NYHA class and greater use of antiarrhythmic drugs. To prevent embolic complication oral anticoagulation should be standard treatment in this group of patients.
Lelakowski
Jacek
J
Uniwersytet Jagielloński w Krakowie, Collegium Medicum, Instytut Kardiologii, Klinika Elektrokardiologii, Krakowski Szpital Specjalistyczny im. Jana Pawla II. jlelakow@szpitaljp2.krakow.pl
Rydlewska
Anna
A
Tomala
Igor
I
Majewski
Jacek
J
Małecka
Barbara
B
Kuniewicz
Marcin
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D012849:Sinoatrial Node / Q000503:physiopathology; D055815:Young Adult