Document Detail

Atrial fibrillation signal organization predicts sinus rhythm maintenance in patients undergoing cardioversion of atrial fibrillation.
MedLine Citation:
PMID:  16831838     Owner:  NLM     Status:  MEDLINE    
AIMS: Electrical remodelling is believed to influence the outcome following cardioversion of patients with persistent atrial fibrillation (AF). However, the results in clinical studies are conflicting. We assessed the hypothesis that non-invasively obtained atrial fibrillatory organization can be used as a predictor of sinus rhythm (SR) maintenance. METHODS AND RESULTS: Fifty-four patients (37 men, age 67+/-11) with persistent AF (median duration 3 months, 1 day to 18 months), without anti-arrhythmic drug treatment, referred for cardioversion were studied. Assessment of the atrial harmonic decay was made by time-frequency analysis of the ECG. At 1-month follow-up, 30 patients had relapsed into AF. The mean harmonic decay at inclusion of those relapsing into AF was 1.5+/-0.3 compared with 1.1+/-0.3 among those maintaining SR (P=0.0004). Using a cut-off value of harmonic decay <or=1.5 to determine suitability for cardioversion would have resulted in a clinically useful discriminator (sensitivity=92%, specificity=47%, PPV=59%, and NPV=88%). CONCLUSION: This study shows that patients relapsing rapidly to AF have a higher harmonic decay than those maintaining SR. The degree of AF signal organization (harmonic decay) was a superior discriminator to other patient parameters. Further studies are needed to confirm these results and to determine the electrophysiological correlate of harmonic decay.
Fredrik Holmqvist; Martin Stridh; Johan E P Waktare; Anders Roijer; Leif Sörnmo; Pyotr G Platonov; Carl J Meurling
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2006-07-10
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  8     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-25     Completed Date:  2006-12-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  559-65     Citation Subset:  IM    
Department of Cardiology, Lund University Hospital, SE-221 85 Lund, Sweden.
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MeSH Terms
Arrhythmia, Sinus / physiopathology
Atrial Fibrillation / physiopathology*,  therapy*
Electric Countershock / methods*
Heart Atria / physiopathology
Heart Conduction System / physiology
Middle Aged
Predictive Value of Tests
Sex Characteristics
Sinoatrial Node / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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