| Electrocardiographic measurements of regional atrial fibrillation cycle length. | |
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MedLine Citation:
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PMID: 19250115 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Differences in atrial fibrillation (AF) cycle length (CL) between the left (LA) and right (RA) atrium and coronary sinus (CS) may help separate paroxysmal from persistent AF and identify patients most likely to respond to pulmonary vein isolation, but has not been measured noninvasively. METHODS AND RESULTS: We developed methods to estimate regional intraatrial AF CL from the surface electrocardiogram (ECG) in 20 patients with persistent AF and 10 patients with paroxysmal AF prior to ablation. Intraatrial AF CL was measured near the LA appendage, mid-CS, and lateral RA. In simultaneous filtered ECG, AF CL was estimated using autocorrelation. The mean of ECG-derived AF CL in leads V5, I, and aVL was used to estimate LA CL; leads aVF, II, and III for CS CL; and V1, V2, and aVR for RA CL. ECG CL estimates for the LA, CS, and RA had R(2) > 0.91 versus measured CL (all P < 0.001). Though magnitudes of left-versus-right AF CL gradients were small in this series, the ECG predicted the direction of gradients in 62% of measurements (P < 0.05). When the gradient was >10 ms, the direction was accurately predicted in eight of 11 patients. The accuracy of AF CL estimates was not adversely affected by AF type or LA dilatation (< or =40 or >40 mm). The ECG-estimated AF-CL showed high 5-minute temporal stability (P < 0.001 each chamber). CONCLUSIONS: Left and right atrial AF CL, and their gradients, can be accurately determined from the ECG using autocorrelation analysis. This approach may be a helpful guide prior to ablation procedures. |
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Authors:
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Krishna C Ravi; David E Krummen; Ailinh J Tran; John R Bullinga; Sanjiv M Narayan |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 32 Suppl 1 ISSN: 1540-8159 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-03-02 Completed Date: 2009-05-29 Revised Date: 2011-04-14 |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: S66-71 Citation Subset: IM |
Affiliation:
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University of California and Veterans Affairs Medical Center, San Diego, California 92161, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Algorithms* Atrial Fibrillation / diagnosis*, physiopathology* Diagnosis, Computer-Assisted / methods* Electrocardiography / methods* Female Heart Rate* Humans Male Middle Aged Pattern Recognition, Automated / methods* Reproducibility of Results Sensitivity and Specificity |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL083359-01A1/HL/NHLBI NIH HHS; R01 HL083359-02/HL/NHLBI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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