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Eur J Cardiothorac Surg 1999;15:525-527
© 1999 Elsevier Science NL

Multicenter results of TADpole^TM heart wire system used to treat postoperative atrial fibrillation¹

European Multicenter Study Group, Department for Cardiovascular Surgery, Herz-Kreislauf-Klinik Bevensen, Römstedter Str. 25, 29549 Bad Bevensen, Germany

Received 23 September 1998; received in revised form 31 December 1998; accepted 13 January 1999.

Corresponding author.

Objective: Postoperative atrial fibrillation (AF) affects 20–30% of patients undergoing open-heart surgery, delays mobilization and impairs hemodynamics. Implantation of TADpole^TM Heart Wires offers a new method of applying internal low-energy-shocks to terminate AF. The safety and efficacy of the TADpole^TM system to treat postoperative AF was evaluated in this multicenter trial. Methods: Two atrial wires, configured with a highly flexible 11.5 cm distal shocking and a 0.5 cm proximal pacing electrode were sutured onto the right and left atrium. Upon detection of AF, R-wave synchronized low-energy-shocks were administered via an energy attenuating External Defibrillator Interface Module or ICD programmer. Results: A total of 296 patients (65±9.2 years, 74.7% male) have been enrolled to date in six European centers. The wire placement time was 4.2±2.2 min, 65 patients had a total of 83 episodes of AF treated by the TADpole^TM Heart Wire system with a conversion rate of 88.5% (approximate energy of 6±2 J), early recurrence of AF was observed in ten patients (12.8%). No clinical complications were reported. The shocks were well tolerated with slight sedation. The ease of withdrawal was 2.3±1.2 on a graded scale of 0 (easy) to 10 (difficult). Conclusions: These multicenter results indicate that postoperative atrial cardioversion using TADpole^TM Heart Wires is both safe and efficient. It is expected that hospital length of stay and its associated economic impact can be reduced with this therapy.

Key Words: Atrial fibrillation • Cardioversion • Open heart surgery