S-4
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Implantable atrial defibrillator
with ventricular back-up
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Werner Jung, Christian Wolpert,
Susanne Spehl, Bahman Esmailzadeh*, Dirk Tenzer, Burghard Schumacher, Berndt Lüderitz.
Departments of Medicine-Cardiology and * Cardiovascular Surgery, University of
Bonn, Bonn, Germany
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Abstract
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Recently, a new dual-chamber defibrillator (Arrhythmia
Management Device, AMD, model 7250, Medtronic Inc., Minneapolis, MN) has entered clinical
evaluation. The 7250 AMD, with a weight of 93 g and a volume of 55 ml, can be programmed
to detect four types of arrhythmias: atrial tachycardia, atrial fibrillation (AF),
ventricular tachycardias and fibrillation. The most important new features of the 7250 AMD
system include: dual-chamber pacing, a new dual-chamber detection criterion for rejection
of supraventricular tachycardias, detection and treatment modalities of atrial
arrhythmias, prevention strategies for atrial arrhythmias. The dual-chamber detection
criterion is constantly monitoring the rhythm in the ventricle as well as in the atrium.
This new dual-chamber detection algorithm is used to improve discrimination of ventricular
tachycardia from supraventricular tachycardia by applying pattern recognition methods
based on different P-wave positions within RR sequences. The detection algorithm can be
used to withhold inappropriate ventricular therapies. Preliminary experience with this new
arrhythmia management system that combines both detection and treatment in the atrium as
well as in the ventricle indicates a significant improvement in the management of patients
with both supraventricular and ventricular tachyarrhythmias.
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Key Words
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Implantable cardioverter defibrillator -
function, indications
dual chamber pacing, dual chamber detection algorithm, discrimination ventricular
arrhythmias versus supraventricular arrhythmias, therapy of ventricular arrhythmias versus
supraventricular arrhythmias, prevention, OA
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