14th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 2000

Jan. 29 - Feb. 5, 2000
Marilleva, Trento, Italy

RT-148

Chemical atrial defibrillation using minimal doses of antiarrhythmic drug delivered in the temporarily occluded coronary sinus. First clinical experience and implications for an implantable device

Giuseppe Vergara, Domenico Catanzariti, Fulvio Cozzi, Roberto Accardi, Walter Spagnolli, Leonardo Cammilli*.
Division of Cardiology, S.Maria del Carmine Hospital, Rovereto, *Cardiac Surgery Lab., USL10D, Firenze, Italy

Current therapies for the management of the patients with atrial fibrillation (AF) include antiarrhythmic drugs, electrical devices (pacemakers, defibrillators) and RF catheter ablation. Nevertheless the clinical results in long-term management of patients with AF still remain unsatisfactory.

Among the more “unconventional” options, the pharmacological atrial defibrillator might represent an useful option. The development of a device based on the delivery of an antiarrhythmic drug into the right atrium or the superior vena cava has already been proposed. However this method of drug delivery is no different from a standard intravenous infusion with similar implications for drug dosage, side effects and clinical efficacy and thus new strategies must be explored.

Here we report the first experience in humans of a new pharmacological atrial defibrillation that could be implemented in an implantable device using minimal doses of an antiarrhythmic drug delivered near the origin of the left atrium oblique vein (Marshall vein) in the temporarily occluded coronary sinus (CS).

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