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ECG-based Assessment and Therapeutic Implications of AV Nodal Conduction Dynamics During Atrial Fibrillation

Karlsson, Mattias LU ; Wallman, Mikael ; Platonov, Pyotr G. LU ; Ulimoen, Sara R. and Sandberg, Frida LU (2023) 50th Computing in Cardiology, CinC 2023 In Computing in Cardiology 50.
Abstract

The conduction properties of the atrioventricular (AV) node have a significant impact on heart rate during permanent atrial fibrillation (AF), and can be modulated through the use of β-blockers or calcium channel blockers. These drugs have different physiological effects and are often selected empirically. Hence, an improved understanding of how these drugs affect the AV node conduction properties may contribute to personalized treatment of AF. We propose a novel methodology for estimating the refractory period and conduction delay dynamics of the fast and slow pathways of the AV node from 24-hour ambulatory ECG recordings. Our approach comprises a network model of the AV node, a problem-specific genetic algorithm, and an approximate... (More)

The conduction properties of the atrioventricular (AV) node have a significant impact on heart rate during permanent atrial fibrillation (AF), and can be modulated through the use of β-blockers or calcium channel blockers. These drugs have different physiological effects and are often selected empirically. Hence, an improved understanding of how these drugs affect the AV node conduction properties may contribute to personalized treatment of AF. We propose a novel methodology for estimating the refractory period and conduction delay dynamics of the fast and slow pathways of the AV node from 24-hour ambulatory ECG recordings. Our approach comprises a network model of the AV node, a problem-specific genetic algorithm, and an approximate Bayesian computation algorithm for estimating the posterior distribution of the AV node properties. We analyzed 24-hour ambulatory ECG recordings at baseline from 51 patients with permanent AF. Interestingly, a moderate correlation between the short-term variability in the refractory period for the fast pathway and reduction in heart rate during treatment with metoprolol (ρ = 0.48, p < 0.005) was found. Thus, the proposed methodology enables individualized characterization of the AV node and can potentially assist in treatment selection.

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author
; ; ; and
organization
publishing date
type
Chapter in Book/Report/Conference proceeding
publication status
published
subject
host publication
Computing in Cardiology, CinC 2023
series title
Computing in Cardiology
volume
50
publisher
IEEE Computer Society
conference name
50th Computing in Cardiology, CinC 2023
conference location
Atlanta, United States
conference dates
2023-10-01 - 2023-10-04
external identifiers
  • scopus:85182337718
ISSN
2325-887X
2325-8861
ISBN
9798350382525
DOI
10.22489/CinC.2023.158
project
Ph.D. project: Non-invasive analysis of ANS activity in atrial fibrillation
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2023 CinC.
id
1ad2073a-7c62-4fc4-99fc-8a458865e0fe
date added to LUP
2024-01-26 10:33:17
date last changed
2024-04-26 07:28:42
@inproceedings{1ad2073a-7c62-4fc4-99fc-8a458865e0fe,
  abstract     = {{<p>The conduction properties of the atrioventricular (AV) node have a significant impact on heart rate during permanent atrial fibrillation (AF), and can be modulated through the use of β-blockers or calcium channel blockers. These drugs have different physiological effects and are often selected empirically. Hence, an improved understanding of how these drugs affect the AV node conduction properties may contribute to personalized treatment of AF. We propose a novel methodology for estimating the refractory period and conduction delay dynamics of the fast and slow pathways of the AV node from 24-hour ambulatory ECG recordings. Our approach comprises a network model of the AV node, a problem-specific genetic algorithm, and an approximate Bayesian computation algorithm for estimating the posterior distribution of the AV node properties. We analyzed 24-hour ambulatory ECG recordings at baseline from 51 patients with permanent AF. Interestingly, a moderate correlation between the short-term variability in the refractory period for the fast pathway and reduction in heart rate during treatment with metoprolol (ρ = 0.48, p &lt; 0.005) was found. Thus, the proposed methodology enables individualized characterization of the AV node and can potentially assist in treatment selection.</p>}},
  author       = {{Karlsson, Mattias and Wallman, Mikael and Platonov, Pyotr G. and Ulimoen, Sara R. and Sandberg, Frida}},
  booktitle    = {{Computing in Cardiology, CinC 2023}},
  isbn         = {{9798350382525}},
  issn         = {{2325-887X}},
  language     = {{eng}},
  publisher    = {{IEEE Computer Society}},
  series       = {{Computing in Cardiology}},
  title        = {{ECG-based Assessment and Therapeutic Implications of AV Nodal Conduction Dynamics During Atrial Fibrillation}},
  url          = {{http://dx.doi.org/10.22489/CinC.2023.158}},
  doi          = {{10.22489/CinC.2023.158}},
  volume       = {{50}},
  year         = {{2023}},
}