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Non-invasive assessment of the atrial cycle length during atrial fibrillation in man: introducing, validating and illustrating a new ECG method

Holm, Magnus; Pehrson, Steen; Ingemansson, Max LU ; Sörnmo, Leif LU ; Johansson, Rolf LU ; Sandhall, Lennart; Sunemark, Max; Smideberg, Birgit LU ; Olsson, Christian and Olsson, Bertil LU (1998) In Cardiovascular Research 38(1). p.69-81
Abstract
OBJECTIVES: Atrial fibrillation (AF) in man has previously been shown to include a wide variety of atrial activity. Assessment of the characteristics of this arrhythmia with a commonly applicable tool may therefore be important in the choice and evaluation of different therapeutic strategies. As the AF cycle length has been shown to correlate locally with atrial refractoriness and globally with the degree of atrial organization, with, in general, shorter cycle length during apparently random AF compared to more organized AF, we have developed a new method for non-invasive assessment of the AF cycle length using the surface and the esophagus (ESO) ECG. METHODS AND RESULTS: From the frequency spectrum of the residual ECG, created by... (More)
OBJECTIVES: Atrial fibrillation (AF) in man has previously been shown to include a wide variety of atrial activity. Assessment of the characteristics of this arrhythmia with a commonly applicable tool may therefore be important in the choice and evaluation of different therapeutic strategies. As the AF cycle length has been shown to correlate locally with atrial refractoriness and globally with the degree of atrial organization, with, in general, shorter cycle length during apparently random AF compared to more organized AF, we have developed a new method for non-invasive assessment of the AF cycle length using the surface and the esophagus (ESO) ECG. METHODS AND RESULTS: From the frequency spectrum of the residual ECG, created by suppression of the QRST complexes, the dominant atrial cycle length (DACL) was derived. By comparison with multiple intracardiac simultaneously acquired right and left AF cycle lengths in patients with paroxysmal AF, we found that the DACL in lead V1, ranging from 130 to 185 ms, well represented a spatial average of the right AF cycle lengths, whereas the DACL in the ESO ECG, ranging from 140 to 185 ms, reflected both the right and the left AF cycle length, where the influence from each structure depended on the atrial anatomy of the individual, as determined by MRI. In patients with chronic AF, the method was capable of following changes in the AF cycle length due to administration of D,L-sotalol and 5 min of ECG recording was sufficient for the DACL to be reproducible. CONCLUSIONS: We conclude that this new non-invasive method, named 'Frequency Analysis of Fibrillatory ECG' (FAF-ECG), is capable of assessing both the magnitude and the dynamics of the atrial fibrillation cycle length in man. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Frequency analysis, ECG, Human, Atrium, Fibrillation, Cycle length, Non-invasive technique
in
Cardiovascular Research
volume
38
issue
1
pages
69 - 81
publisher
Elsevier
external identifiers
  • pmid:9683908
  • scopus:0032051662
ISSN
1755-3245
DOI
10.1016/S0008-6363(97)00289-7
language
English
LU publication?
yes
id
5c123ed4-d1cd-4968-9eb5-506f355991c5 (old id 1114032)
date added to LUP
2008-07-16 15:29:39
date last changed
2017-10-08 03:41:18
@article{5c123ed4-d1cd-4968-9eb5-506f355991c5,
  abstract     = {OBJECTIVES: Atrial fibrillation (AF) in man has previously been shown to include a wide variety of atrial activity. Assessment of the characteristics of this arrhythmia with a commonly applicable tool may therefore be important in the choice and evaluation of different therapeutic strategies. As the AF cycle length has been shown to correlate locally with atrial refractoriness and globally with the degree of atrial organization, with, in general, shorter cycle length during apparently random AF compared to more organized AF, we have developed a new method for non-invasive assessment of the AF cycle length using the surface and the esophagus (ESO) ECG. METHODS AND RESULTS: From the frequency spectrum of the residual ECG, created by suppression of the QRST complexes, the dominant atrial cycle length (DACL) was derived. By comparison with multiple intracardiac simultaneously acquired right and left AF cycle lengths in patients with paroxysmal AF, we found that the DACL in lead V1, ranging from 130 to 185 ms, well represented a spatial average of the right AF cycle lengths, whereas the DACL in the ESO ECG, ranging from 140 to 185 ms, reflected both the right and the left AF cycle length, where the influence from each structure depended on the atrial anatomy of the individual, as determined by MRI. In patients with chronic AF, the method was capable of following changes in the AF cycle length due to administration of D,L-sotalol and 5 min of ECG recording was sufficient for the DACL to be reproducible. CONCLUSIONS: We conclude that this new non-invasive method, named 'Frequency Analysis of Fibrillatory ECG' (FAF-ECG), is capable of assessing both the magnitude and the dynamics of the atrial fibrillation cycle length in man.},
  author       = {Holm, Magnus and Pehrson, Steen and Ingemansson, Max and Sörnmo, Leif and Johansson, Rolf and Sandhall, Lennart and Sunemark, Max and Smideberg, Birgit and Olsson, Christian and Olsson, Bertil},
  issn         = {1755-3245},
  keyword      = {Frequency analysis,ECG,Human,Atrium,Fibrillation,Cycle length,Non-invasive technique},
  language     = {eng},
  number       = {1},
  pages        = {69--81},
  publisher    = {Elsevier},
  series       = {Cardiovascular Research},
  title        = {Non-invasive assessment of the atrial cycle length during atrial fibrillation in man: introducing, validating and illustrating a new ECG method},
  url          = {http://dx.doi.org/10.1016/S0008-6363(97)00289-7},
  volume       = {38},
  year         = {1998},
}