{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T19:43:30Z","timestamp":1757706210567},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2003,7,22]],"date-time":"2003-07-22T00:00:00Z","timestamp":1058832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2003,8]]},"abstract":"<jats:p> <jats:italic>Introduction:<\/jats:italic> The atrial defibrillator empowers patients to cardiovert themselves from atrial arrhythmias at a time that is socially and physically acceptable, thereby preventing hospitalization. The long\u2010term psychosocial effects of repeated use of the patient\u2010activated atrial defibrillator at home are unknown.<\/jats:p><jats:p> <jats:italic>Methods and Results:<\/jats:italic> Eighteen patients underwent placement of the Jewel AF atrial defibrillator for persistent atrial fibrillation only. All patients performed manually activated cardioversions at home under self\u2010administered sedation. Automatic shock therapies were disabled. Hospital Anxiety and Depression Scale and Multidimensional Health Locus of Control questionnaires were obtained before implant. All patients completed questionnaires 1 year after device implant and at long\u2010term follow\u2010up. The spouse or partner of each patient was interviewed to identify positive and negative aspects of manual cardioversion at home. The baseline patient scores for both anxiety <jats:styled-content>(5.7 \u00b1 2.7)<\/jats:styled-content> and depression <jats:styled-content>(3.4 \u00b1 2.3)<\/jats:styled-content> fell within the predefined range of normality. At 1 year, there was no significant change in anxiety <jats:styled-content>(4.9 \u00b1 3.7, P = 0.39)<\/jats:styled-content> or depression <jats:styled-content>(2.4 \u00b1 1.8, P = 0.06)<\/jats:styled-content>. At long\u2010term follow\u2010up (mean 28 months), a total of 377 patient\u2010activated cardioversions were performed out of hospital (median 15 per patient). Scores for anxiety <jats:styled-content>(6.0 \u00b1 4.0, P = 0.70)<\/jats:styled-content> and depression <jats:styled-content>(3.2 \u00b1 2.5, P = 0.68)<\/jats:styled-content> remained unchanged.<\/jats:p><jats:p> <jats:italic>Conclusion:<\/jats:italic> During long\u2010term follow\u2010up, patient\u2010activated cardioversion using the atrial defibrillator was not associated with increased anxiety or depression. The procedure was well tolerated by patients and their partners, offering an acceptable treatment option for patients with recurrent persistent atrial fibrillation. <jats:italic>(J Cardiovasc Electrophysiol, Vol. 14, pp. 812\u2010816, August 2003)<\/jats:italic><\/jats:p>","DOI":"10.1046\/j.1540-8167.2003.03108.x","type":"journal-article","created":{"date-parts":[[2003,7,22]],"date-time":"2003-07-22T10:15:13Z","timestamp":1058868913000},"page":"812-816","source":"Crossref","is-referenced-by-count":11,"title":["Psychosocial Aspects of Patient\u2010Activated Atrial Defibrillation"],"prefix":"10.1111","volume":"14","author":[{"given":"Andrew R.J.","family":"Mitchell","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip 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