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ECG based assessment of circadian variation in AV-nodal conduction during AF—Influence of rate control drugs

Karlsson, Mattias LU ; Wallman, Mikael ; Platonov, Pyotr G. LU ; Ulimoen, Sara R. and Sandberg, Frida LU (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
; ; ; and
organization
publishing date
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
2024-04-18 08:39:28
@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}},
}