ArticleJournal of the American College of Cardiology
Multistage electrotherapy delivered through chronically-implanted leads terminates atrial fibrillation with lower energy than a single biphasic shock.
Article in Journal of the American College of Cardiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 13 papers.
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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.
Measurement of Low-energy Stimulation in Patients With Atrial Fibrillation
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
13 citing papers in PubMed, 28 citations in OpenAlex.
- Success rates of simulated multi-pulse defibrillation protocols are sensitive to application timing with individual, protocol-specific optimal timings.Frontiers in network physiology · 2025Article
- Chaos control in cardiac dynamics: terminating chaotic states with local minima pacing.Frontiers in network physiology · 2024Article
- Electrical Stimulation for Low-Energy Termination of Cardiac Arrhythmias: a Review.Cardiovascular drugs and therapy · 2023Review
- Optimising low-energy defibrillation in 2D cardiac tissue with a genetic algorithm.Frontiers in network physiology · 2023Article
- Non-monotonous dose response function of the termination of spiral wave chaos.Scientific reports · 2022Article
- The role of pulse timing in cardiac defibrillation.Frontiers in network physiology · 2022Article
- Novel Low-Voltage MultiPulse Therapy to Terminate Atrial Fibrillation.JACC. Clinical electrophysiology · 2021Article
- Conceptual Intra-Cardiac Electrode Configurations That Facilitate Directional Cardiac Stimulation for Optimal Electrotherapy.IEEE transactions on bio-medical engineering · 2019Article
- Innovations in Clinical Cardiac Electrophysiology: Challenges and Upcoming Solutions in 2018 and Beyond.The Journal of innovations in cardiac rhythm management · 2017Review
- Mechanisms of vortices termination in the cardiac muscle.Royal Society open science · 2017Article
- A Magnetic Resonance Imaging-Conditional External Cardiac Defibrillator for Resuscitation Within the Magnetic Resonance Imaging Scanner Bore.Circulation. Cardiovascular imaging · 2016Article
- Imaging of Ventricular Fibrillation and Defibrillation: The Virtual Electrode Hypothesis.Advances in experimental medicine and biology · 2015Review
- Toward microendoscopy-inspired cardiac optogenetics in vivo: technical overview and perspective.Journal of biomedical optics · 2014Review
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectivesThe goal of this study was to develop a low-energy, implantable device-based multistage electrotherapy (MSE) to terminate atrial fibrillation (AF).
backgroundPrevious attempts to perform cardioversion of AF by using an implantable device were limited by the pain caused by use of a high-energy single biphasic shock (BPS).
methodsTransvenous leads were implanted into the right atrium (RA), coronary sinus, and left pulmonary artery of 14 dogs. Self-sustaining AF was induced by 6 ± 2 weeks of high-rate RA pacing. Atrial defibrillation thresholds of standard versus experimental electrotherapies were measured in vivo and studied by using optical imaging in vitro.
resultsThe mean AF cycle length (CL) in vivo was 112 ± 21 ms (534 beats/min). The impedances of the RA-left pulmonary artery and RA-coronary sinus shock vectors were similar (121 ± 11 Ω vs. 126 ± 9 Ω; p = 0.27). BPS required 1.48 ± 0.91 J (165 ± 34 V) to terminate AF. In contrast, MSE terminated AF with significantly less energy (0.16 ± 0.16 J; p < 0.001) and significantly lower peak voltage (31.1 ± 19.3 V; p < 0.001). In vitro optical imaging studies found that AF was maintained by localized foci originating from pulmonary vein-left atrium interfaces. MSE Stage 1 shocks temporarily disrupted localized foci; MSE Stage 2 entrainment shocks continued to silence the localized foci driving AF; and MSE Stage 3 pacing stimuli enabled consistent RA-left atrium activation until sinus rhythm was restored.
conclusionsLow-energy MSE significantly reduced the atrial defibrillation thresholds compared with BPS in a canine model of AF. MSE may enable painless, device-based AF therapy.
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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.