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Title: Waveform optimisation for internal cardioversion of atrial fibrillation
Author: Kodoth, Vivek Nambiar
ISNI:       0000 0004 2742 054X
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2012
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Direct current transthoracic cardioversion is a well-established treatment for atrial fibrillation (AF). Significant changes in the device technology have taken place since the procedure was first described. Since then there has been a constant quest to improve the efficacy of the device by optimising various parameters that affect the success of cardioversion. Particular waveforms used in different models of defibrillators determine the energy used and efficacy of defibrillators. The technique of internal cardioversion was developed to treat patients in whom transthoracic cardioversion was unsuccessful. The aims of this thesis was to address issues surrounding optimisation of internal cardioversion. Data from this thesis will help. in developing a novel atrial defibrillator. Commercially available internal and external cardioversion devices use a capacitor based exponential energy. A unique radiofrequency energy powered defibrillator was developed at the Royal Victoria Hospital in collaboration with the Centre for Advanced Cardiovascular Research (University of Ulster). This device was extensively studied both in animal models and clinical studies at the Royal Victoria Hospital, Belfast. In this study, I compared the safety and efficacy of a novel radiofrequency low tilt monophasic waveform with a low tilt biphasic waveform for internal cardioversion of persistent AF. All the persistent AF patients had a previous history of failed external cardioversion. I also compared the waveforms in patients who inadvertently go into AF during electrophysiological studies. In both the studies, significant proportion of patients were successfully cardioverted to sinus rhythm with low energy. The radiofrequency powered defibrillator was safely used for transvenous cardioversion of atrial fibrillation. In this thesis, I have discussed about cardioversion, internal cardioversion, atrial defibrillators, various waveforms used for cardioversion, development of radiofrequency defibrillator and the concept of novel atrial defibrillator. Data from my work will add to the development of a novel radiofrequency atrial defibrillator. This device will eventually contain a passive implantable atrial defibrillator that is powered by an externally transmitted pulse of RF energy.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available