Indications for an atrial defibrillator.

Atrial fibrillation is a chronic progressive disease, variable in its expression, but capable of producing considerable symptoms and morbidity. Current therapies are limited in their effectiveness and produce side effects that vary from merely annoying to life threatening. Initial clinical trials of an implanted atrial defibrillator in a selected population have been promising. Early results with patients controlling the conversion of out-of-hospital recurrences of atrial fibrillation suggest that the therapy is well tolerated and successful in converting atrial fibrillation to sinus rhythm. No proarrhythmia has been observed, and the attrition to chronic atrial fibrillation has been very low.