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- W1984902076 abstract "Atrial Defibrillation. Introduction: The aim of this study was to identify determinants of first-shock success for defibrillation of spontaneous atrial fibrillation (AF) in ambulatory patients with an atrial implantable cardioverter defibrillator (ICD). The determinants of first-shock success in ambulatory patients with atrial ICDs are unknown. Methods and Results: We used the generalized estimating equation method to analyze determinants of first-shock success in 50 consecutive atrial ICD recipients in whom DFT+ (weakest shock that defibrillates on two consecutive trials) was determined at implant and spontaneous AF was shocked with shock strength > 2 × DFT+. DFT+ was 6.2 ± 3.1 J. Of 470 first shocks, 407 were successful (generalized estimating equation 85%, confidence interval 79% to 90%). Determinants of first-shock success were use of coronary sinus electrode (univariate P = 0.02; multivariate P < 0.001, relative risk 5.0), absence of a Class III antiarrhythmic drug (univariate P = 0.06; multivariate P < 0.001, relative risk 3.2), absence of early recurrence of atrial fibrillation (ERAF; univariate P = 0.06; multivariate P = 0.02, relative risk 2.9), and longer duration of AF prior to shock > 3 hours (univariate: P = 0.02; multivariate P = NS). Sinus rhythm > 1 minute persisted after 93% of first shocks in patients without documented ERAF but after only 58% of shocks in patients with documented ERAF (P < 0.001). Conclusion: Reducing ERAF is critical to achieving a clinically acceptable rate of persistent sinus rhythm after first shocks. For first shocks > 2 × DFT+, success is not increased by programming stronger shocks. Early cardioversion does not increase first-shock success." @default.
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- W1984902076 date "2002-04-01" @default.
- W1984902076 modified "2023-10-16" @default.
- W1984902076 title "Determinants of First-Shock Success for Atrial Implantable Cardioverter Defibrillators" @default.
- W1984902076 doi "https://doi.org/10.1046/j.1540-8167.2002.00347.x" @default.
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