Advanced

Atrial fibrillatory rate and risk of left atrial thrombus in atrial fibrillation.

Bollmann, Andreas LU ; Husser, Daniela; Stridh, Martin LU ; Holmqvist, Fredrik LU ; Roijer, Anders LU ; Meurling, Carl LU ; Sörnmo, Leif LU and Olsson, Bertil LU (2007) In Europace 9(8). p.6-621
Abstract
ims In atrial fibrillation (AF), a relation between electrocardiogram (ECG) fibrillatory wave amplitude and thrombus formation has been sought for long with conflicting results. In contrast, the possible relation between atrial fibrillatory rate obtained from the surface ECG and left atrial thrombus formation in patients with AF is unknown and was consequently evaluated in this study.



Methods and results One-hundred and twenty-five patients (mean age 64 ± 12 years, 72% male) with persistent non-valvular AF (mean duration 28 ± 80 days) undergoing transesophageal echocardiography were studied. In all patients, standard 12-lead ECG recordings were acquired before the examination. Atrial fibrillatory rate was determined... (More)
ims In atrial fibrillation (AF), a relation between electrocardiogram (ECG) fibrillatory wave amplitude and thrombus formation has been sought for long with conflicting results. In contrast, the possible relation between atrial fibrillatory rate obtained from the surface ECG and left atrial thrombus formation in patients with AF is unknown and was consequently evaluated in this study.



Methods and results One-hundred and twenty-five patients (mean age 64 ± 12 years, 72% male) with persistent non-valvular AF (mean duration 28 ± 80 days) undergoing transesophageal echocardiography were studied. In all patients, standard 12-lead ECG recordings were acquired before the examination. Atrial fibrillatory rate was determined using spatiotemporal QRST cancellation and time–frequency analysis of lead V1. Atrial fibrillatory rate measured 401 ± 63 fibrillations per minute (fpm, range 235–566 fpm) and was related with age (R = −0.326, P < 0.001), ventricular rate (R = −0.202, P = 0.024), gender (407 ± 62 in males vs. 387 ± 64 fpm in females, P = 0.038) but not AF duration (R = 0.088, P = 0.374), presence of lone AF (408 ± 66 vs. 394 ± 58 fpm, P = 0.228), or beta-blocker or calcium channel blocker treatment (398 ± 63 vs. 405 ± 62 fpm, P = 0.556). Age was the only independent predictor of fibrillatory rate (B = −1.714, P < 0.001).



In patients with left atrial thrombus (n = 10), spontaneous echo contrast (SEC) was more frequently present (70 vs. 29 %, p = 0.007) and left atrial appendage (LAA) outflow velocity was lower (26 ± 20 vs. 37 ± 15 cm/s, P = 0.012) than in patients without thrombus (n = 115). In contrast, mean fibrillatory rate, which showed a weak inverse correlation with LAA velocity (R = −0.118, P = 0.048) was not different between both groups (380 ± 56 vs. 403 ± 63 fpm, P = 0.226). Similarly, presence of thrombus and SEC combined was not related with fibrillatory rate.



Conclusion Atrial fibrillatory rate obtained from surface ECG lead V1 is not a risk marker for left atrial thrombus formation in AF. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Europace
volume
9
issue
8
pages
6 - 621
publisher
Oxford University Press
external identifiers
  • wos:000249915000013
  • scopus:34547947284
ISSN
1532-2092
DOI
10.1093/europace/eum125
language
English
LU publication?
yes
id
6e1604b5-1814-4c91-bc98-bab522258673 (old id 541121)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17604306&dopt=Abstract
date added to LUP
2008-01-04 11:14:14
date last changed
2017-01-01 04:29:27
@article{6e1604b5-1814-4c91-bc98-bab522258673,
  abstract     = {ims In atrial fibrillation (AF), a relation between electrocardiogram (ECG) fibrillatory wave amplitude and thrombus formation has been sought for long with conflicting results. In contrast, the possible relation between atrial fibrillatory rate obtained from the surface ECG and left atrial thrombus formation in patients with AF is unknown and was consequently evaluated in this study.<br/><br>
<br/><br>
Methods and results One-hundred and twenty-five patients (mean age 64 ± 12 years, 72% male) with persistent non-valvular AF (mean duration 28 ± 80 days) undergoing transesophageal echocardiography were studied. In all patients, standard 12-lead ECG recordings were acquired before the examination. Atrial fibrillatory rate was determined using spatiotemporal QRST cancellation and time–frequency analysis of lead V1. Atrial fibrillatory rate measured 401 ± 63 fibrillations per minute (fpm, range 235–566 fpm) and was related with age (R = −0.326, P &lt; 0.001), ventricular rate (R = −0.202, P = 0.024), gender (407 ± 62 in males vs. 387 ± 64 fpm in females, P = 0.038) but not AF duration (R = 0.088, P = 0.374), presence of lone AF (408 ± 66 vs. 394 ± 58 fpm, P = 0.228), or beta-blocker or calcium channel blocker treatment (398 ± 63 vs. 405 ± 62 fpm, P = 0.556). Age was the only independent predictor of fibrillatory rate (B = −1.714, P &lt; 0.001).<br/><br>
<br/><br>
In patients with left atrial thrombus (n = 10), spontaneous echo contrast (SEC) was more frequently present (70 vs. 29 %, p = 0.007) and left atrial appendage (LAA) outflow velocity was lower (26 ± 20 vs. 37 ± 15 cm/s, P = 0.012) than in patients without thrombus (n = 115). In contrast, mean fibrillatory rate, which showed a weak inverse correlation with LAA velocity (R = −0.118, P = 0.048) was not different between both groups (380 ± 56 vs. 403 ± 63 fpm, P = 0.226). Similarly, presence of thrombus and SEC combined was not related with fibrillatory rate.<br/><br>
<br/><br>
Conclusion Atrial fibrillatory rate obtained from surface ECG lead V1 is not a risk marker for left atrial thrombus formation in AF.},
  author       = {Bollmann, Andreas and Husser, Daniela and Stridh, Martin and Holmqvist, Fredrik and Roijer, Anders and Meurling, Carl and Sörnmo, Leif and Olsson, Bertil},
  issn         = {1532-2092},
  language     = {eng},
  number       = {8},
  pages        = {6--621},
  publisher    = {Oxford University Press},
  series       = {Europace},
  title        = {Atrial fibrillatory rate and risk of left atrial thrombus in atrial fibrillation.},
  url          = {http://dx.doi.org/10.1093/europace/eum125},
  volume       = {9},
  year         = {2007},
}