ECG based assessment of circadian variation in AV-nodal conduction during AF—Influence of rate control drugs
(2022) In Frontiers in Physiology 13.- Abstract
The heart rate during atrial fibrillation (AF) is highly dependent on the conduction properties of the atrioventricular (AV) node. These properties can be affected using β-blockers or calcium channel blockers, mainly chosen empirically. Characterization of individual AV-nodal conduction could assist in personalized treatment selection during AF. Individual AV nodal refractory periods and conduction delays were characterized based on 24-hour ambulatory ECGs from 60 patients with permanent AF. This was done by estimating model parameters from a previously created mathematical network model of the AV node using a problem-specific genetic algorithm. Based on the estimated model parameters, the circadian variation and its drug-dependent... (More)
The heart rate during atrial fibrillation (AF) is highly dependent on the conduction properties of the atrioventricular (AV) node. These properties can be affected using β-blockers or calcium channel blockers, mainly chosen empirically. Characterization of individual AV-nodal conduction could assist in personalized treatment selection during AF. Individual AV nodal refractory periods and conduction delays were characterized based on 24-hour ambulatory ECGs from 60 patients with permanent AF. This was done by estimating model parameters from a previously created mathematical network model of the AV node using a problem-specific genetic algorithm. Based on the estimated model parameters, the circadian variation and its drug-dependent difference between treatment with two β-blockers and two calcium channel blockers were quantified on a population level by means of cosinor analysis using a linear mixed-effect approach. The mixed-effects analysis indicated increased refractoriness relative to baseline for all drugs. An additional decrease in circadian variation for parameters representing conduction delay was observed for the β-blockers. This indicates that the two drug types have quantifiable differences in their effects on AV-nodal conduction properties. These differences could be important in treatment outcome, and thus quantifying them could assist in treatment selection.
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- author
- Karlsson, Mattias LU ; Wallman, Mikael ; Platonov, Pyotr G. LU ; Ulimoen, Sara R. and Sandberg, Frida LU
- organization
- publishing date
- 2022-10-04
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- atrial fibrillation, atrioventricular node, circadian variation, ECG, genetic algorithm, mathematical modeling, mixed effect modeling, rate control drugs
- in
- Frontiers in Physiology
- volume
- 13
- article number
- 976526
- pages
- 13 pages
- publisher
- Frontiers Media S. A.
- external identifiers
-
- pmid:36267586
- scopus:85139926966
- ISSN
- 1664-042X
- DOI
- 10.3389/fphys.2022.976526
- project
- Ph.D. project: Non-invasive analysis of ANS activity in atrial fibrillation
- Diagnostic Biomarkers in Atrial Fibrillation - Autonomic Nervous System Response as a Sign of Disease Progression
- language
- English
- LU publication?
- yes
- additional info
- Funding Information: This work was supported by the Swedish Foundation for Strategic Research (Grant FID18-0023), the Swedish Research Council (Grant VR 2019–04272), and the Crafoord Foundation (Grant 20200605). Publisher Copyright: Copyright © 2022 Karlsson, Wallman, Platonov, Ulimoen and Sandberg.
- id
- 2f5b9448-5cc0-4370-a142-1c3268876496
- date added to LUP
- 2022-10-25 16:44:49
- date last changed
- 2024-08-08 18:38:20
@article{2f5b9448-5cc0-4370-a142-1c3268876496, abstract = {{<p>The heart rate during atrial fibrillation (AF) is highly dependent on the conduction properties of the atrioventricular (AV) node. These properties can be affected using β-blockers or calcium channel blockers, mainly chosen empirically. Characterization of individual AV-nodal conduction could assist in personalized treatment selection during AF. Individual AV nodal refractory periods and conduction delays were characterized based on 24-hour ambulatory ECGs from 60 patients with permanent AF. This was done by estimating model parameters from a previously created mathematical network model of the AV node using a problem-specific genetic algorithm. Based on the estimated model parameters, the circadian variation and its drug-dependent difference between treatment with two β-blockers and two calcium channel blockers were quantified on a population level by means of cosinor analysis using a linear mixed-effect approach. The mixed-effects analysis indicated increased refractoriness relative to baseline for all drugs. An additional decrease in circadian variation for parameters representing conduction delay was observed for the β-blockers. This indicates that the two drug types have quantifiable differences in their effects on AV-nodal conduction properties. These differences could be important in treatment outcome, and thus quantifying them could assist in treatment selection.</p>}}, author = {{Karlsson, Mattias and Wallman, Mikael and Platonov, Pyotr G. and Ulimoen, Sara R. and Sandberg, Frida}}, issn = {{1664-042X}}, keywords = {{atrial fibrillation; atrioventricular node; circadian variation; ECG; genetic algorithm; mathematical modeling; mixed effect modeling; rate control drugs}}, language = {{eng}}, month = {{10}}, publisher = {{Frontiers Media S. A.}}, series = {{Frontiers in Physiology}}, title = {{ECG based assessment of circadian variation in AV-nodal conduction during AF—Influence of rate control drugs}}, url = {{http://dx.doi.org/10.3389/fphys.2022.976526}}, doi = {{10.3389/fphys.2022.976526}}, volume = {{13}}, year = {{2022}}, }