ArticleCirculation. Arrhythmia and electrophysiology2011
Low-energy multistage atrial defibrillation therapy terminates atrial fibrillation with less energy than a single shock.
Article in Circulation. Arrhythmia and electrophysiology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Clinical Feasibility Study to Evaluate the Safety and Performance of Low-Energy Unpinning Termination Therapy in Patients With VT
An International Clinical Feasibility Study to Evaluate the Safety and Performance of Low-Energy Unpinning Termination Therapy in Patients With VT/VF
A Clinical Feasibility Study to Evaluate the Safety and Performance of Low-Energy Therapy in Patients With Atrial Fibrillation Energy Therapy in Patients With Atrial Fibrillation
A Clinical Feasibility Study to Evaluate the Safety and Performance of Low-Energy Therapy in Patients With Atrial Fibrillation (US)
Who cites it
18 citing papers in PubMed, 55 citations in OpenAlex.
- A Beginner's Guide to Cardiac Optical Mapping.Cardiovascular engineering and technology · 2026Review
- Atrial fibrillation and flutter conversion with pulsed electric field delivery: preclinical proof of concept.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Scientific Priorities Related to the Use of Double Sequential External Defibrillation in Patients With Refractory Cardiac Arrest: Report From a Multistakeholder Thinktank.Journal of the American Heart Association · 2025Article
- Injectable ionic hydrogel conductors: Advancing material design to transform cardiac pacing.Biomaterials · 2025Article
- Experimental studies of spiral wave teleportation in a light sensitive Belousov-Zhabotinsky system.Chaos (Woodbury, N.Y.) · 2024Article
- Impact of Combined Modulation of Two Potassium Ion Currents on Spiral Waves and Turbulent States in the Heart.Entropy (Basel, Switzerland) · 2024Article
- Electrical Stimulation for Low-Energy Termination of Cardiac Arrhythmias: a Review.Cardiovascular drugs and therapy · 2023Review
- Terminating spiral waves with a single designed stimulus: Teleportation as the mechanism for defibrillation.Proceedings of the National Academy of Sciences of the United States of America · 2022Article
- Methodology for Cross-Talk Elimination in Simultaneous Voltage and Calcium Optical Mapping Measurements With Semasbestic Wavelengths.Frontiers in physiology · 2022Article
- Novel Low-Voltage MultiPulse Therapy to Terminate Atrial Fibrillation.JACC. Clinical electrophysiology · 2021Article
- A real-time system for selectively sensing and pacing the His-bundle during sinus rhythm and ventricular fibrillation.Biomedical engineering online · 2020Article
- Isosbestic Point in Optical Mapping; Theoretical and Experimental Determination With Di-4-ANBDQPQ Transmembrane Voltage Sensitive Dye.Computing in cardiology · 2019Article
- Computational rabbit models to investigate the initiation, perpetuation, and termination of ventricular arrhythmia.Progress in biophysics and molecular biology · 2016Review
- George Ralph Mines (1886-1914): the dawn of cardiac nonlinear dynamics.The Journal of physiology · 2016Article
- New insights into defibrillation of the heart from realistic simulation studies.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2014Review
- Terminating ventricular tachyarrhythmias using far-field low-voltage stimuli: mechanisms and delivery protocols.Heart rhythm · 2013Article
- Advances in modeling ventricular arrhythmias: from mechanisms to the clinic.Wiley interdisciplinary reviews. Systems biology and medicineReview
- Multistage electrotherapy delivered through chronically-implanted leads terminates atrial fibrillation with lower energy than a single biphasic shock.Journal of the American College of CardiologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundImplantable device therapy of atrial fibrillation (AF) is limited by pain from high-energy shocks. We developed a low-energy multistage defibrillation therapy and tested it in a canine model of AF. METHODS AND
resultsAF was induced by burst pacing during vagus nerve stimulation. Our novel defibrillation therapy consisted of 3 stages: stage (ST) 1 (1-4 low-energy biphasic [BP] shocks), ST2 (6-10 ultralow-energy monophasic [MP] shocks), and ST3 (antitachycardia pacing). First, ST1 testing compared single or multiple MP and BP shocks. Second, several multistage therapies were tested: ST1 versus ST1+ST3 versus ST1+ST2+ST3. Third, 3 shock vectors were compared: superior vena cava to distal coronary sinus, proximal coronary sinus to left atrial appendage, and right atrial appendage to left atrial appendage. The atrial defibrillation threshold (DFT) of 1 BP shock was <1 MP shock (0.55 ± 0.1 versus 1.38 ± 0.31 J, P=0.003). Two to 3 BP shocks terminated AF with lower peak voltage than 1 BP or 1 MP shock and with lower atrial DFT than 4 BP shocks. Compared with ST1 therapy alone, ST1+ST3 lowered the atrial DFT moderately (0.51 ± 0.46 versus 0.95 ± 0.32 J, P=0.036), whereas 3-stage therapy (ST1+ST2+ST3) dramatically lowered the atrial DFT (0.19 ± 0.12 versus 0.95 ± 0.32 J for ST1 alone, P=0.0012). Finally, the 3-stage therapy was equally effective for all studied vectors.
conclusionsThree-stage electrotherapy significantly reduces the AF DFT and opens the door to low-energy atrial defibrillation at or below the pain threshold.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.