Criteria for Selection of Patients with Atrial Fibrillation to Receive a Dual-Site ICD

  • E. Occhetta
  • F. Paltrinieri
  • C. Vassanelli
Conference paper


Atrial fibrillation is the most common sustained tachyarrhythmia and is increasing in prevalence as the population ages [1,2]. It causes symptoms such as palpitations and dyspnea, but is also associated with stroke, heart failure, and an increasing risk of hospitalization and death. Over one-third of hospital admissions for arrhythmias are secondary to atrial fibrillation [3]. Restoration and maintenance of normal sinus rhythm by means of cardioversion is the first treatment option for clinicians. The choice of therapeutic intervention is generally guided by the severity and duration of the patients’ symptoms and their tolerance or response to intervention.


Atrial Fibrillation Implantable Cardioverter Defibrillator Normal Sinus Rhythm Atrial Arrhythmia Atrial Pace 


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  1. 1.
    Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D (1998) Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation 98:946–952PubMedCrossRefGoogle Scholar
  2. 2.
    Wolf PA, Mitchell JB, Baker CS, Kannel WB, D’Agostino RB (1998) Impact of atrial fibrillation on mortality, stroke, and medical costs. Ann Intern Med 158:229–234CrossRefGoogle Scholar
  3. 3.
    Baily D, Lehmann MH, Schumacher DN, Steinman RT, Meissner MD (1992) Hospitalization for arrhythmias in the United States: importance of atrial fibrillation. Am J Cardiol 19:14AGoogle Scholar
  4. 4.
    Wijffels M, Kirschhof C, Boersma L, Allessie M (1994) Atrial fibrillation begets atrial fibrillation. In: Atrial fibrillation: mechanisms and therapeutic strategies. Futura, Armonk, pp 195–201Google Scholar
  5. 5.
    Nattel S, Hadjis T, Talajic M (1994) The treatment of atrial fibrillation: an evaluation of drug therapy, electrical modalities and therapeutic consideration. Drugs 48:345–371PubMedCrossRefGoogle Scholar
  6. 6.
    Ganz LI, Antman EM (1997) Antiarrhythmic drug therapy in the management of atrial fibrillation. J Cardiovasc Electrophysiol 8:1175–1189PubMedCrossRefGoogle Scholar
  7. 7.
    Cosio FG, Palacios J, Vidal JM, Cocina EG, Gomez-Sanchez MA, Tamargo L (1983) Electrophysiologic studies in atrial fibrillation: slow conduction of premature impulses: a possible manifestation of the background for reentry. Am J Cardiol 51:122–130PubMedCrossRefGoogle Scholar
  8. 8.
    Waktare JE, Hnatkova K, Sopher SM et al (1992) The role of atrial ectopics in initiating paroxysmal atrial fibrillation. J Am Coll Cardiol 19:1531–1535CrossRefGoogle Scholar
  9. 9.
    Garrigue S, Barold SS, Cazeau S et al (1998) Prevention of atrial arrhythmias during DDD pacing by atrial overdrive. Pacing Clin Electrophysiol 21:1751–1759PubMedCrossRefGoogle Scholar
  10. 10.
    Carlson MD (2001)The atrial dynamic overdrive pacing trial. North American Society of Pacing and Electrophysiology, Boston, May 2001Google Scholar
  11. 11.
    Goette A, Honeycutt C, Langberg JJ (1996) Electrical remodeling in atrial fibrillation: time course and mechanisms. Circulation 94:2968–2974PubMedCrossRefGoogle Scholar
  12. 12.
    Fromer M, Gloor H, Kus T, Shenasa M (1990) Clinical experience with a new software based antitachycardia pacemaker for recurrent supraventricular and ventricular tachycardias. Pacing Clin Electrophysiol 13:890–899PubMedCrossRefGoogle Scholar
  13. 13.
    Connelly DT, De Belder MA, Cunningham D et al (2000) Long-term follow up of patients treated with a software based antitachycardia pacemaker. Circulation 102:1407–1413CrossRefGoogle Scholar
  14. 14.
    Guidant METRIX Implantable Atrial Defibrillator Annual Progress Report. Guidant Inc., USA, May 2000Google Scholar
  15. 15.
    Medtronic Jewel AF 7250 Dual-Chamber Implantable Cardioverter Defibrillator System Summary of Safety and Effectiveness. Medtronic Inc., USA, 14 June 2000Google Scholar
  16. 16.
    Best PJ, Hayes DL, Stanton MS (1999) The potential usage of dual chamber pacing in patients with implantable cardioverter defibrillators. Pacing Clin Electrophysiol 22:79–85PubMedCrossRefGoogle Scholar
  17. 17.
    Friedman PA, Dijkman B, Warman EN et al (2001) Atrial therapies reduce atrial arrhythmia burden in defibrillator patients. Circulation 104:1023–1028PubMedCrossRefGoogle Scholar
  18. 18.
    Cooper JM, Katcher MS, Orlov MV (2002) Implantable devices for the treatment of atrial fibrillation. N Engl J Med 346:2062–2068PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2003

Authors and Affiliations

  • E. Occhetta
    • 1
  • F. Paltrinieri
    • 2
  • C. Vassanelli
    • 1
  1. 1.Divisione Clinicizzata di Cardiologia, Facoltà di Medicina e Chirurgia di NovaraUniversità degli Studi del Piemonte OrientaleNovara
  2. 2.Guidant ItaliaMilanItaly

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