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Left atrial appendage activity translation in the standard 12-lead ECG

Platonov, Pyotr LU ; Nault, Isabelle; Holmqvist, Fredrik LU ; Stridh, Martin LU ; Hocini, M and Haissaguerre, M (2011) In Journal of Cardiovascular Electrophysiology 22(6). p.706-710
Abstract (Swedish)
Abstract in Undetermined

LAA Activity in Surface ECG. Introduction: Interatrial frequency gradient is used to guide catheter ablation of atrial fibrillation (AF). Lead V1 adequately reflects right atrial activity, but reliable tools for noninvasive estimation of right versus left fibrillatory frequency are lacking. In this study, patients with dissociated left and right atrial rhythms were studied in order to identify which surface electrocardiographic (ECG) leads that most closely reflect the left atrial activity.



Methods: Two consecutive patients with atrial tachycardia confined to the left atrial appendage (LAA) detected during catheter ablation of AF were included (2 men, 54 and 72 years old). A... (More)
Abstract in Undetermined

LAA Activity in Surface ECG. Introduction: Interatrial frequency gradient is used to guide catheter ablation of atrial fibrillation (AF). Lead V1 adequately reflects right atrial activity, but reliable tools for noninvasive estimation of right versus left fibrillatory frequency are lacking. In this study, patients with dissociated left and right atrial rhythms were studied in order to identify which surface electrocardiographic (ECG) leads that most closely reflect the left atrial activity.



Methods: Two consecutive patients with atrial tachycardia confined to the left atrial appendage (LAA) detected during catheter ablation of AF were included (2 men, 54 and 72 years old). A 12-lead ECG was recorded simultaneously with electrograms from the right and left atrial appendages (RAA/LAA). AF frequency spectra were calculated from all 12 leads using spatiotemporal QRST cancellation and Welch periodogram. The dominating atrial cycle length (DACL) in the surface ECG leads was subsequently compared with the invasively measured LAA cycle length.



Results: LAA activation frequency was seen as a prominent peak in the frequency–power spectrum derived from frontal plane leads as well as lead V1. The absolute difference in noninvasively and invasively measured LAA cycle length was lowest for leads aVR, II, aVF, III, and V1 in which it was in the range of 2–4 ms.



Conclusion: Prominent left atrial component is present in the majority of standard ECG leads, including those traditionally associated with right atrial activity such as V1. Spectral analysis is able to extract the LAA component on surface ECG. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
atrial fibrillation, interatrial frequency gradient, left atrium, noninvasive
in
Journal of Cardiovascular Electrophysiology
volume
22
issue
6
pages
706 - 710
publisher
Wiley-Blackwell
external identifiers
  • pmid:21040094
  • wos:000292422100013
  • scopus:79959235099
ISSN
1540-8167
DOI
10.1111/j.1540-8167.2010.01909.x
language
English
LU publication?
yes
id
7a4d39ee-7d63-4371-af10-8c468940505b (old id 2225633)
date added to LUP
2011-12-15 15:02:19
date last changed
2017-01-01 07:34:00
@article{7a4d39ee-7d63-4371-af10-8c468940505b,
  abstract     = {<b>Abstract in Undetermined</b><br/><br>
LAA Activity in Surface ECG. Introduction: Interatrial frequency gradient is used to guide catheter ablation of atrial fibrillation (AF). Lead V1 adequately reflects right atrial activity, but reliable tools for noninvasive estimation of right versus left fibrillatory frequency are lacking. In this study, patients with dissociated left and right atrial rhythms were studied in order to identify which surface electrocardiographic (ECG) leads that most closely reflect the left atrial activity.<br/><br>
<br/><br>
Methods: Two consecutive patients with atrial tachycardia confined to the left atrial appendage (LAA) detected during catheter ablation of AF were included (2 men, 54 and 72 years old). A 12-lead ECG was recorded simultaneously with electrograms from the right and left atrial appendages (RAA/LAA). AF frequency spectra were calculated from all 12 leads using spatiotemporal QRST cancellation and Welch periodogram. The dominating atrial cycle length (DACL) in the surface ECG leads was subsequently compared with the invasively measured LAA cycle length.<br/><br>
<br/><br>
Results: LAA activation frequency was seen as a prominent peak in the frequency–power spectrum derived from frontal plane leads as well as lead V1. The absolute difference in noninvasively and invasively measured LAA cycle length was lowest for leads aVR, II, aVF, III, and V1 in which it was in the range of 2–4 ms.<br/><br>
<br/><br>
Conclusion: Prominent left atrial component is present in the majority of standard ECG leads, including those traditionally associated with right atrial activity such as V1. Spectral analysis is able to extract the LAA component on surface ECG.},
  author       = {Platonov, Pyotr and Nault, Isabelle and Holmqvist, Fredrik and Stridh, Martin and Hocini, M and Haissaguerre, M},
  issn         = {1540-8167},
  keyword      = {atrial fibrillation,interatrial frequency gradient,left atrium,noninvasive},
  language     = {eng},
  number       = {6},
  pages        = {706--710},
  publisher    = {Wiley-Blackwell},
  series       = {Journal of Cardiovascular Electrophysiology},
  title        = {Left atrial appendage activity translation in the standard 12-lead ECG},
  url          = {http://dx.doi.org/10.1111/j.1540-8167.2010.01909.x},
  volume       = {22},
  year         = {2011},
}