Comparing the efficacy and safety of a novel monophasic waveform delivered by the passive implantable atrial defibrillator with biphasic waveforms in cardioversion of atrial fibrillation

G Manoharan, N Evans, D Allen, JMCC Anderson, J Adgey

    Research output: Contribution to journalArticle

    8 Citations (Scopus)

    Abstract

    Background - The passive implantable atrial defibrillator (PIAD) ( with no battery or discharging capacitor and powered transcutaneously by radio-frequency energy) delivering a novel monophasic low-tilt waveform is more efficacious than the standard monophasic waveform at atrial defibrillation. Standard biphasic (STB) waveforms, however, are more efficacious and safer than monophasic waveforms. This study compared the efficacy and safety of the PIAD waveform with biphasic waveforms. Methods and Results - Sustained atrial fibrillation (AF) was induced by rapid atrial pacing. Cardioversion was attempted via 2 atrial defibrillation leads. The efficacy of the PIAD was compared with 3 biphasic waveforms ( standard, single rounded, and double rounded) at varying voltage settings in 10 pigs. After a synchronized shock, hemodynamic changes between the PIAD, standard biphasic, and monophasic waveforms were compared at 1.5 and 3.0 J in 12 pigs. Myocardial injury ( biochemical and histological) after ten 5-J PIAD shocks was compared with a no-shock group in 14 pigs. The PIAD 100-V setting was significantly more efficacious than the STB (100/-50 V: 100% [1.88 +/- 0.02 J] versus 90% [0.89 +/- 0.0 J]; P = 0.025). No arrhythmic, hemodynamic, or myocardial injury was observed with the PIAD waveform. Conclusions - Defibrillation with the PIAD is more efficacious than with the STB waveform and appears safe. This device could provide a more effective option for cardioversion.
    LanguageEnglish
    Pages1686-1692
    JournalCirculation
    Volume109
    Issue number13
    DOIs
    Publication statusPublished - Apr 2004

    Fingerprint

    Electric Countershock
    Implantable Defibrillators
    Atrial Fibrillation
    Safety
    Shock
    Swine
    Hemodynamics
    Wounds and Injuries
    Radio
    Equipment and Supplies

    Keywords

    • arrhythmia
    • fibrillation
    • cardioversion

    Cite this

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    title = "Comparing the efficacy and safety of a novel monophasic waveform delivered by the passive implantable atrial defibrillator with biphasic waveforms in cardioversion of atrial fibrillation",
    abstract = "Background - The passive implantable atrial defibrillator (PIAD) ( with no battery or discharging capacitor and powered transcutaneously by radio-frequency energy) delivering a novel monophasic low-tilt waveform is more efficacious than the standard monophasic waveform at atrial defibrillation. Standard biphasic (STB) waveforms, however, are more efficacious and safer than monophasic waveforms. This study compared the efficacy and safety of the PIAD waveform with biphasic waveforms. Methods and Results - Sustained atrial fibrillation (AF) was induced by rapid atrial pacing. Cardioversion was attempted via 2 atrial defibrillation leads. The efficacy of the PIAD was compared with 3 biphasic waveforms ( standard, single rounded, and double rounded) at varying voltage settings in 10 pigs. After a synchronized shock, hemodynamic changes between the PIAD, standard biphasic, and monophasic waveforms were compared at 1.5 and 3.0 J in 12 pigs. Myocardial injury ( biochemical and histological) after ten 5-J PIAD shocks was compared with a no-shock group in 14 pigs. The PIAD 100-V setting was significantly more efficacious than the STB (100/-50 V: 100{\%} [1.88 +/- 0.02 J] versus 90{\%} [0.89 +/- 0.0 J]; P = 0.025). No arrhythmic, hemodynamic, or myocardial injury was observed with the PIAD waveform. Conclusions - Defibrillation with the PIAD is more efficacious than with the STB waveform and appears safe. This device could provide a more effective option for cardioversion.",
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    Comparing the efficacy and safety of a novel monophasic waveform delivered by the passive implantable atrial defibrillator with biphasic waveforms in cardioversion of atrial fibrillation. / Manoharan, G; Evans, N; Allen, D; Anderson, JMCC; Adgey, J.

    In: Circulation, Vol. 109, No. 13, 04.2004, p. 1686-1692.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Comparing the efficacy and safety of a novel monophasic waveform delivered by the passive implantable atrial defibrillator with biphasic waveforms in cardioversion of atrial fibrillation

    AU - Manoharan, G

    AU - Evans, N

    AU - Allen, D

    AU - Anderson, JMCC

    AU - Adgey, J

    PY - 2004/4

    Y1 - 2004/4

    N2 - Background - The passive implantable atrial defibrillator (PIAD) ( with no battery or discharging capacitor and powered transcutaneously by radio-frequency energy) delivering a novel monophasic low-tilt waveform is more efficacious than the standard monophasic waveform at atrial defibrillation. Standard biphasic (STB) waveforms, however, are more efficacious and safer than monophasic waveforms. This study compared the efficacy and safety of the PIAD waveform with biphasic waveforms. Methods and Results - Sustained atrial fibrillation (AF) was induced by rapid atrial pacing. Cardioversion was attempted via 2 atrial defibrillation leads. The efficacy of the PIAD was compared with 3 biphasic waveforms ( standard, single rounded, and double rounded) at varying voltage settings in 10 pigs. After a synchronized shock, hemodynamic changes between the PIAD, standard biphasic, and monophasic waveforms were compared at 1.5 and 3.0 J in 12 pigs. Myocardial injury ( biochemical and histological) after ten 5-J PIAD shocks was compared with a no-shock group in 14 pigs. The PIAD 100-V setting was significantly more efficacious than the STB (100/-50 V: 100% [1.88 +/- 0.02 J] versus 90% [0.89 +/- 0.0 J]; P = 0.025). No arrhythmic, hemodynamic, or myocardial injury was observed with the PIAD waveform. Conclusions - Defibrillation with the PIAD is more efficacious than with the STB waveform and appears safe. This device could provide a more effective option for cardioversion.

    AB - Background - The passive implantable atrial defibrillator (PIAD) ( with no battery or discharging capacitor and powered transcutaneously by radio-frequency energy) delivering a novel monophasic low-tilt waveform is more efficacious than the standard monophasic waveform at atrial defibrillation. Standard biphasic (STB) waveforms, however, are more efficacious and safer than monophasic waveforms. This study compared the efficacy and safety of the PIAD waveform with biphasic waveforms. Methods and Results - Sustained atrial fibrillation (AF) was induced by rapid atrial pacing. Cardioversion was attempted via 2 atrial defibrillation leads. The efficacy of the PIAD was compared with 3 biphasic waveforms ( standard, single rounded, and double rounded) at varying voltage settings in 10 pigs. After a synchronized shock, hemodynamic changes between the PIAD, standard biphasic, and monophasic waveforms were compared at 1.5 and 3.0 J in 12 pigs. Myocardial injury ( biochemical and histological) after ten 5-J PIAD shocks was compared with a no-shock group in 14 pigs. The PIAD 100-V setting was significantly more efficacious than the STB (100/-50 V: 100% [1.88 +/- 0.02 J] versus 90% [0.89 +/- 0.0 J]; P = 0.025). No arrhythmic, hemodynamic, or myocardial injury was observed with the PIAD waveform. Conclusions - Defibrillation with the PIAD is more efficacious than with the STB waveform and appears safe. This device could provide a more effective option for cardioversion.

    KW - arrhythmia

    KW - fibrillation

    KW - cardioversion

    U2 - 10.1161/01.CIR.0000124068.69162.4E

    DO - 10.1161/01.CIR.0000124068.69162.4E

    M3 - Article

    VL - 109

    SP - 1686

    EP - 1692

    JO - Circulation

    T2 - Circulation

    JF - Circulation

    SN - 0009-7322

    IS - 13

    ER -