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Atrial fibrillatory rate in the clinical context: natural course and prediction of intervention outcome.

Platonov, Pyotr LU ; Corino, Valentina D A; Seifert, Mariam LU ; Holmqvist, Fredrik LU and Sörnmo, Leif (2014) In Europace 16 Suppl 4. p.110-119
Abstract
Shortening of atrial refractory period during atrial fibrillation has been considered a hallmark of atrial electrical remodelling. The atrial fibrillatory cycle length, which is intimately related to the atrial fibrillatory rate (AFR), is generally accepted as a surrogate marker for local refractoriness. The value of using AFR to monitor the progress of atrial ablation therapy has been demonstrated and gradual slowing of AFR has consistently been observed to precede arrhythmia termination during paroxysmal or permanent atrial fibrillation ablation. Today, AFR is the key characteristic of the fibrillatory process, repeatedly validated against intracardiac recordings and extensively studied in clinical contexts. This paper provides an... (More)
Shortening of atrial refractory period during atrial fibrillation has been considered a hallmark of atrial electrical remodelling. The atrial fibrillatory cycle length, which is intimately related to the atrial fibrillatory rate (AFR), is generally accepted as a surrogate marker for local refractoriness. The value of using AFR to monitor the progress of atrial ablation therapy has been demonstrated and gradual slowing of AFR has consistently been observed to precede arrhythmia termination during paroxysmal or permanent atrial fibrillation ablation. Today, AFR is the key characteristic of the fibrillatory process, repeatedly validated against intracardiac recordings and extensively studied in clinical contexts. This paper provides an overview of clinical data accumulated since the method was introduced in 1998, and to present the current state of knowledge regarding ECG-derived AFR: its time course and dynamics, clinical factors affecting AFR, and available evidence of its value in the clinical context. We conclude that AFR is a promising, easily available AF characteristic that can be derived from the conventional surface ECG. It is clearly a useful tool for monitoring drug effects. Reference values for predicting intervention effect, however, are likely to be population- and context-specific and related to age, clinical types of atrial fibrillation, as well as to presence and advancement of underlying structural heart disease. Prospective studies in homogeneous patient populations are still needed to establish the clinical value of AFR. (Less)
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organization
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Contribution to journal
publication status
published
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in
Europace
volume
16 Suppl 4
pages
110 - 119
publisher
Oxford University Press
external identifiers
  • pmid:25362161
  • scopus:84923531287
ISSN
1532-2092
DOI
10.1093/europace/euu249
language
English
LU publication?
yes
id
af8646a8-b975-44d4-9820-1a4efe241d45 (old id 4820439)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25362161?dopt=Abstract
date added to LUP
2014-12-01 18:22:44
date last changed
2017-03-19 04:17:14
@article{af8646a8-b975-44d4-9820-1a4efe241d45,
  abstract     = {Shortening of atrial refractory period during atrial fibrillation has been considered a hallmark of atrial electrical remodelling. The atrial fibrillatory cycle length, which is intimately related to the atrial fibrillatory rate (AFR), is generally accepted as a surrogate marker for local refractoriness. The value of using AFR to monitor the progress of atrial ablation therapy has been demonstrated and gradual slowing of AFR has consistently been observed to precede arrhythmia termination during paroxysmal or permanent atrial fibrillation ablation. Today, AFR is the key characteristic of the fibrillatory process, repeatedly validated against intracardiac recordings and extensively studied in clinical contexts. This paper provides an overview of clinical data accumulated since the method was introduced in 1998, and to present the current state of knowledge regarding ECG-derived AFR: its time course and dynamics, clinical factors affecting AFR, and available evidence of its value in the clinical context. We conclude that AFR is a promising, easily available AF characteristic that can be derived from the conventional surface ECG. It is clearly a useful tool for monitoring drug effects. Reference values for predicting intervention effect, however, are likely to be population- and context-specific and related to age, clinical types of atrial fibrillation, as well as to presence and advancement of underlying structural heart disease. Prospective studies in homogeneous patient populations are still needed to establish the clinical value of AFR.},
  author       = {Platonov, Pyotr and Corino, Valentina D A and Seifert, Mariam and Holmqvist, Fredrik and Sörnmo, Leif},
  issn         = {1532-2092},
  language     = {eng},
  pages        = {110--119},
  publisher    = {Oxford University Press},
  series       = {Europace},
  title        = {Atrial fibrillatory rate in the clinical context: natural course and prediction of intervention outcome.},
  url          = {http://dx.doi.org/10.1093/europace/euu249},
  volume       = {16 Suppl 4},
  year         = {2014},
}