Clinical Study Of Internal Atrial Defibrillation In The Treatment Of Patients With Atrial Fibrillation

BackgroundAtrial fibrillation (AF) is one of the most common arrhythmia and increases the morbidity and mortality. Restoring sinus rhythm is the main aim of the treatment. External cardioversion associated with higher defibrillation energy and deep sedation. Antiarrhythmic drugs had lower conversion rate and proarrhythmic side effects. Transvenous atrial defibrillation is highly effective in converting AF to sinus rhythm. The fact that AF begets AF due to atrial remodeling, which paristly involved by Ca~+ overload strongly implicates early cardioversion of AF. Implantable atrial defibrillator (IAD) and its combination with implantable devices may play an important role in the treatment of different subset patients with AF. The aims of this study are to assess the clinical efficacy of transvenous atrial defibrillation with low energy biphasic shocks between right atrium and coronary sinus in the treatment of patients with acute and chronic AF, to introduce the initial usage of the stand-alone IAD in patients with recurrent AF, to evaluate the effect of Calcium-channel blocker, verapamil on AF burden in patients with an IAD, and to investigate the implication of combining atrial defibrillation mode into a dual chamber pacemaker for patients with sick sinus syndrome, and to compare the efficacy of ventricular defibrillation lead system for atrial defibrillation with or without a CS defibrillation lead, and finally, to assess the serial changes of both atrial and ventricular function after prompt cardioversion.