Copyright © 1998 by the European Society of Cardiology.
Non-invasive assessment of magnitude and dispersion of atrial cycle length during chronic atrial fibrillation in man
a Department of Cardiology, University Hospital of Lund, Lund, Sweden
b Department of Applied Electronics, Lund University, Lund, Sweden
accepted June 17, 1998
Aims
Atrial fibrillation cycle lengths can be assessed from right precordial ECG leads and the unipolar oesophageal ECG using a non-invasive method called Frequency Analysis of Fibrillatory ECG. The purpose of this report is to present the results from application of this method in a large group of patients with long-term atrial fibrillation and to examine the differences between patients with ‘coarse’ and ‘fine’ atrial fibrillation.
Methods and Results
Simultaneous 15min recordings from V1, V2and an oesophageal lead at a position behind the posterior atrium were obtained in 28 patients, aged 41 to 78 years, with long-term (>1 month) atrial fibrillation. In each lead, using the time averaging technique, the QRST complexes were suppressed. Thereafter, the frequency distribution of the residual ECG was estimated by means of Fast Fourier Transform. In the 3–12Hz range of each lead, the dominant atrial cycle length, the power maximum and the spectral width were calculated.
In 26 patients (93%), frequency spectra in the 3–12Hz range could be obtained. The dominant atrial cycle length ranged from 120 to 175ms, mean 150±16 (SD) ms in V1, and from 120 to 190ms, mean 150±16 in an oesophageal lead (ns). The absolute difference in the dominant atrial cycle length between V1and the oesophageal lead was 10·4±7·7ms. There was no significant difference in the dominant atrial cycle length in V1between patients with coarse and fine atrial fibrillation. The power maximum in V1was significantly greater in patients with coarse compared to fine atrial fibrillation (P=0·01). The spectral widths ranged from 10 to 55ms and demonstrated significantly higher mean values in lead V2compared to V1(P=0·001). Compared to V1, the mean values tended to be smaller in the oesophageal lead (P=0·05).
Conclusions
Using the Frequency Analysis of Fibrillatory ECG method, the dominant atrial cycle length, power maximum and spectral width can be estimated from the frequency spectra in the majority of patients with atrial fibrillation. Spatial dispersion of the dominant atrial cycle length occurs in some patients and may be an important proarrhythmic marker. The distinction between coarse and fine atrial fibrillation cannot be used as a marker of the atrial cycle length.
Key Words: Atrial cycle length • atrial fibrillation • oesophageal ECG • non-invasive • precordial leads • spectral analysis
f1 Correspondence: Steen Pehrson, MD, PhD, Department of Cardiology, P, Amtssygehuset i Gentofte, DK-2900 Hellerup, Denmark.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Bollmann, D. Husser, L. Mainardi, F. Lombardi, P. Langley, A. Murray, J. J. Rieta, J. Millet, S. B. Olsson, M. Stridh, et al. Analysis of surface electrocardiograms in atrial fibrillation: techniques, research, and clinical applications. Europace, November 1, 2006; 8(11): 911 - 926. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Holmqvist, M. Stridh, J. E.P. Waktare, L. Sornmo, S. B. Olsson, and C. J. Meurling Atrial fibrillatory rate and sinus rhythm maintenance in patients undergoing cardioversion of persistent atrial fibrillation Eur. Heart J., September 2, 2006; 27(18): 2201 - 2207. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Holmqvist, M. Stridh, J. E.P. Waktare, A. Roijer, L. Sornmo, P. G. Platonov, and C. J. Meurling Atrial fibrillation signal organization predicts sinus rhythm maintenance in patients undergoing cardioversion of atrial fibrillation Europace, August 1, 2006; 8(8): 559 - 565. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Holmqvist, M. Stridh, J. E. P. Waktare, J. Brandt, L. Sornmo, A. Roijer, and C. J. Meurling Rapid fluctuations in atrial fibrillatory electrophysiology detected during controlled respiration Am J Physiol Heart Circ Physiol, August 1, 2005; 289(2): H754 - H760. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Mansour, R. Mandapati, O. Berenfeld, J. Chen, F. H. Samie, and J. Jalife Left-to-Right Gradient of Atrial Frequencies During Acute Atrial Fibrillation in the Isolated Sheep Heart Circulation, May 29, 2001; 103(21): 2631 - 2636. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C.J. Meurling, M.P. Ingemansson, A. Roijer, J. Carlson, C.J. Lindholm, B. Smideberg, L. Sorno, M. Stridh, and S.B. Olsson Attenuation of electrical remodelling in chronic atrial fibrillation following oral treatment with verapamil Europace, January 1, 1999; 1(4): 234 - 241. [Abstract] [PDF]
|
|