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Do Patients Accept Implantable Atrial Defibrillation Therapy?

Results from the Patient Atrial Shock Survey of Acceptance and Tolerance (PASSAT) Study


  • This study was supported by Medtronic Inc., Minneapolis, Minnesota.

  • Manuscript received 4 August 2003; Accepted for publication 16 October 2003.

Address for correspondence: Samuel F. Sears, Ph.D., Department of Clinical & Health Psychology, University of Florida, Box 100165, UF Health Science Center, Gainesville, FL 32610. Fax: 352-273-6156; E-mail:


Introduction: The Medtronic Jewel AF 7250 is an implantable cardioverter defibrillator with atrial and ventricular therapies (ICD-AT). The ICD-AT is effective in managing atrial tachyarrhythmias (atrial fibrillation [AF]), but patient acceptance remains an issue. This aim of this study was to measure ICD-AT acceptance.

Methods and Results: ICD-AT acceptance was evaluated in 96 patients enrolled in the “Jewel AF-AF-Only Study” for ≥3 months of follow-up (mean 19 months). Patients were mostly men (72%; age 65 ± 12 years). Clinical data and a written survey (75% response rate) were used to quantify demographics, AF frequency and symptoms, atrial defibrillation therapy, quality of life (QOL), psychosocial distress, and ICD-AT therapy acceptance. From implant to survey, AF symptom and severity scores decreased by 18% (P ≤ 0.05), and QOL (SF-36) scores increased by 15% to 50% (P ≤ 0.05). ICD-AT therapy acceptance was high, with 71.3% of patients scoring in the 75th percentile on the Florida Patient Acceptance Survey. ICD-AT acceptance was correlated with the Physical Component Scale and Mental Health Component Scale scores of the SF-36 (r = 0.28 and 0.35, respectively). ICD-AT acceptance was negatively correlated with depressive symptomatology (r =–0.59), trait anxiety (r =–0.48), illness intrusiveness (r =–0.55), and AF symptom and severity scores (r =–0.26). ICD-AT acceptance did not correlate with preimplant cardioversions, number of atrial shocks, AF episodes detected by the device, or device implant duration.

Conclusion: Most patients accepted ICD-AT therapy. Patients were more likely to accept ICD-AT if they had less psychosocial distress, greater QOL, and lower AF symptom burden. (J Cardiovasc Electrophysiol, Vol. 15, pp. 286-291, March 2004)

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