Novel Passive Implantable Atrial Defibrillator Using Transcutaneous Radiofrequency Energy Transmission Successfully Cardioverts Atrial Fibrillation
Novel Passive Implantable Atrial Defibrillator Using Transcutaneous Radiofrequency Energy Transmission Successfully Cardioverts Atrial Fibrillation
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新型被动植入式心房除颤器利用经皮射频能量传输成功治疗心房颤动
DOI：
10.1161/01.cir.0000087594.42881.3c
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
J. Adgey
中科院分区：
文献类型：
--
作者：
G. Manoharan;N. Evans;B. Kidwai;Desmond Allen;J. Anderson;J. Adgey
背景-传统的心房颤动（AF）转复为窦性心律的方法有许多困难。在急性动物模型中测试了一种使用被动植入式心房除颤器（PIAD）进行心脏复律的新方法。该器械没有电池或电容器来储存能量，通过将RF能量从外部发射器经皮肤传输到皮下植入除颤器来激活。激活时，通过2根心内除颤电极导线向心脏输送具有5%倾斜度的新型双相电击波形。方法和结果-在两个阶段评估了使用该设备的心脏复律尝试：可行性和有效性研究以及与标准波形的随机比较。将除颤电极导线经腹置入远端冠状窦和右心耳。这些连接到皮下植入的PIAD。快速心房起搏诱发持续性房颤。将发射器线圈放置在除颤器上的皮肤上，并尝试与R波同步的除颤。发现该方法在非常低的电压和能量下有效，对于10 ms 100 V电击（平均能量，1.54±0.02 J），观察到100%心脏复律成功。PIAD波形的心脏复律成功率高于截短的70%倾斜双相指数脉冲（100 V，100% vs 78.0±7.57%; P =0.001）。无休克后并发症。结论：考虑到这些动物实验结果，这种方法对于有症状的房颤患者的复律是有希望的。
Background—Conventional methods for cardioversion of atrial fibrillation (AF) to sinus rhythm have numerous difficulties. A novel method for cardioversion using the passive implantable atrial defibrillator (PIAD) was tested in acute animal models. This device does not have a battery or a capacitor to store energy and is activated by transferring RF energy across the skin from an external transmitter to the subcutaneously implanted defibrillator. On activation, a novel monophasic shock waveform with 5% tilt is delivered to the heart via 2 intracardiac defibrillation leads. Methods and Results—Cardioversion attempts with the device were assessed in 2 phases: a feasibility and efficacy study and randomized comparison against standard waveforms. Defibrillation leads were placed transvenously into the distal coronary sinus and the right atrial appendage. These were connected to the subcutaneously implanted PIAD. Sustained AF was induced by rapid atrial pacing. The transmitter coil was placed on the skin overlying the defibrillator, and defibrillation synchronized to the R wave was attempted. The method was found to be efficacious at very low voltage and energy, with 100% cardioversion success observed for 10-ms 100-V shocks (mean energy, 1.54±0.02 J). The PIAD waveform had a higher cardioversion success rate than a truncated, 70% tilt monophasic exponential pulse (100 V, 100% versus 78.0±7.57%; P =0.001). There were no postshock complications. Conclusions—Considering these animal results, this method is promising for cardioverting AF in symptomatic patients.
影响因子：
20.1
作者：
S. Yabe;William M. Smith;J. Daubert;P. Wolf;D. Rollins;R. Ideker
通讯作者：
S. Yabe;William M. Smith;J. Daubert;P. Wolf;D. Rollins;R. Ideker
影响因子：
37.8
作者：
Cooper,RA;Johnson,EE;Wharton,JM
通讯作者：
Wharton,JM