Differentiation between aberrant ventricular conduction and ventricular ectopy in atrial fibrillation using RR interval scattergram.

Suyama, Akiko; Sunagawa, Kenji; Sugimachi, Masaru; Anan, Tsuyoshi; Egashira, Kensuke; Takeshita, Akira

doi:10.1161/01.cir.88.5.2307

Cited by 26 publications

(16 citation statements)

References 14 publications

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“…Because of the high HR during exercise, presence of P waves often cannot be ascertained, thus differentiating wide QRS complex tachycardias as ventricular versus supraventricular in origin may be difficult or impossible. We were not able to differentiate the 2 conduction patterns in our study, because doing so would require intracardiac His bundle electrocardiography recordings . The treadmill test is considered a stressful experience for horses, leading to high sympathetic stimulation, which may explain the HR increase initiated during the warm‐up period, permitting a high number of atrial impulses to be transmitted through the AV node.…”

Section: Discussionmentioning

confidence: 97%

Effect of induced chronic atrial fibrillation on exercise performance in Standardbred trotters

Buhl

Carstensen

Hesselkilde

et al. 2018

Veterinary Internal Medicne

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BackgroundAtrial fibrillation (AF) is the most common arrhythmia affecting performance in horses. However, no previous studies have quantified the performance reduction in horses suffering from AF.ObjectivesTo quantify the effect of AF on maximum velocity (V max), maximum heart rate (HRmax), heart rate recovery (T 100), hematologic parameters and development of abnormal QRS complexes.AnimalsNine Standardbred trotters.MethodsTwo‐arm controlled trial. Six horses had AF induced by means of a pacemaker and 3 served as sham‐operated controls. All horses were subjected to an exercise test to fatigue before (SET1) and after (SET2) 2 months of AF or sham. The V max and HRmax were assessed using a linear mixed normal model. Abnormal QRS complexes were counted manually on surface ECGs.ResultsAtrial fibrillation resulted in a 1.56 m/sec decrease in V max (P < .0001). In the AF group, HRmax ± SD increased from 226 ± 11 bpm at SET1 to 311 ± 27 bpm at SET 2. The AF group had higher HRmax at SET2 compared with controls (P < .0001), whereas no difference between the control and AF groups was observed at SET1 (P = .96). Several episodes of wide complex tachycardia were observed during exercise in 3 of the AF horses during SET2.Conclusions and Clinical ImportanceAtrial fibrillation resulted in a significant reduction in performance, an increase in HR and development of abnormal QRS complexes during exercise, which may be a risk factor for collapse or sudden cardiac death.

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Section: Discussionmentioning

confidence: 97%

Effect of induced chronic atrial fibrillation on exercise performance in Standardbred trotters

Buhl

Carstensen

Hesselkilde

et al. 2018

Veterinary Internal Medicne

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“…In comparison, the reported prevalence of VPDs during exercise in clinically healthy dressage and showjumping horses is 5% [25] and 18% [26]. In human patients, wide QRS complexes are frequently observed in AF [27]. Two different processes could be causing this broadening: ventricular ectopy or aberrant intraventricular conduction of supraventricular impulses [28].…”

Section: Discussionmentioning

confidence: 99%

Ventricular response during lungeing exercise in horses with lone atrial fibrillation

Verheyen

Decloedt

Vekens

et al. 2012

Equine Veterinary Journal

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Summary 10Reasons for performing the study: Atrial fibrillation (AF) is the most important dysrhythmia 11 affecting performance in horses and has been associated with incoordination, collapse and 12 sudden death. Limited information is available on ventricular response during exercise in 13 horses with lone AF. 14 Objectives: To investigate ventricular response in horses with lone AF during a standardised 15 lungeing exercise test. Results: Individual average heart rate during walk ranged from 42 to 175 bpm, during trot 21 from 89 to 207 bpm, during canter from 141 to 269 bpm, and during gallop from 191 to 311 22 bpm. Individual beat-to-beat maximal heart rate ranged from 248 to 492 bpm. Ventricular 23 premature depolarisations were present in 81% of the horses: at rest (16%), during exercise 24 (69%), and during recovery (2%). In 33% of the horses, broad QRS complexes with R-on-T 25 morphology were found. 26Conclusions: Exercising horses with lone AF frequently develop disproportionate tachycardia. 27In addition, QRS broadening and even R-on-T morphology is frequently found. QRS 28 broadening may originate from ventricular ectopic foci or from aberrant intra-ventricular 29 conduction, for example due to bundle branch block. This might explain the high number of 30 complexes currently classified as ventricular premature depolarisations. 31Potential relevance: Prevalence of QRS broadening and especially R-on-T was very high in 32 horses with AF and was found at low levels of exercise. These dysrhythmias are considered 33 risk factors for the development of ventricular tachycardia and fibrillation and they might 34 explain signs of weakness, collapse or sudden death that have been reported in horses with 35 AF. 36Accepted Article 3

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“…al. [56] demonstrated that pairs of RR intervals constructed with aberrant conduction beats were distributed along the lower envelope of the Poincaré plot. Similarly, the coupling points of wide QRS complexes are also distributed along the envelope of the Poincaré plot [103].…”

Section: Discussionmentioning

confidence: 98%

“…the regularity of the ventricular rhythm. In a Poincaré plot, each RR interval is plotted versus the preceding one [54,55,56]; it should be noted that this type of plot is also referred to as the Lorenz plot. It allows a beat-to-beat approach of HRV detecting pattern resulting from non linear processes and it was presented as a clinically useful tool for the study of AV nodal characteristics in AF.…”

Section: Analysis Of the Ventricular Response During Atrial Fibrillationmentioning

confidence: 99%

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Characterization and Modeling of Atrioventricular Conduction during Atrial Fibrillation

Climent¹,

Andreu²

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AgradecimientosLa consecución de la presente tesis hubiese sido completamente imposible sin la colaboración de numerosas personas que me han ayudado, enseñado y apoyado durante estos años. Quiero empezar agradeciendo el apoyo recibido por todos los integrantes del grupo de Bioingeniería del instituto ITACA de la Universidad Politécnica de Valencia desde que empecé a colaborar con ellos en 2005. De todos los que durante este tiempo han pasado por el laboratorio he aprendido muchísimo y tengo un más que grato recuerdo: Jose Luis Espí, José Laparra, Jose Antonio Belloch, Laura Maestro, Vicky Donis, Cinta Barber, Amparo Pomar, María Mozo, Lola Guerrero, Lydia Dux, Martina Srutova, Pietro Bonizzi, Lorena Rausell, Jesús Vila y Xavier Ibáñez. Y por supuesto quiero mandar un caluroso agradecimiento a todos con los que sigo trabajando día a día y de los que cada día aprendo nuevas cosas: Jorge Pedrón, Alejandro Liberos, Eduard Roses, Toni Guill, Alvaro Tormos, José Antonio Pérez, Toni Cebrián, Paco Castells, Conrado Calvo, Amador Ayala, María Vinaches, Cristina Rojas, Adolfo Fonseca, Jesús Escrivá y Miguel Rodrigo. Comentario a parte merece José Millet del cual he aprendido innombrables cosas y cuyo espíritu entusiasta y su capacidad de encajar los problemas con tranquilidad son virtudes que querría tener la capacidad de imitar y que me acompañasen durante el resto de mi carrera.Además del apoyo de todos los compañeros del laboratorio, la realización de las diversas estancias de investigación ha sido imprescindible para que esta tesis haya llegado a buen término. Junto con el Dr. Andreas Bollmann entré en el mundo de la ciencia, deél aprendí algunas de las lecciones más valiosas entre las que quiero destacar elímpetu por colaborar y aprender siempre con los mejores estuviesen en el laboratorio de al lado o a 5000km. Este afán por conseguir enriquecer nuestras investigaciones con el apoyo de algunos de los más reputados expertos del mundo me ha llevado a Milán junto con a la Dra. Valentina Corino y al Dr. Luca Mainardi, a Suecia con los Drs. Martin Stridth y Leif Srnmo, a Cleveland junto con los Drs. Youhua Zhang y Todor Mazgalev y a Michigan junto con los Drs. Omer Berenfeld y José Jalife. Cada una de esas estancias me ha enriquecido no sólo como investigador sino como persona. Poder colaborar con investigadores tan reputados a la vez que grandes personas ha sido un regalo que es difícil de describir en unas pocas palabras pero que viajará i ii AGRADECIMIENTOS conmigo el resto de mi vida. Junto con las colaboraciones internacionales, en mi por ahora corta carrera como investigador he tenido la suerte de trabajar con grandes investigadores españoles entre los que quiero destacar a los Drs. Felipe Atienza, Aurelio Quesada y Javier Chorro por confiar en nosotros pese a nuestra juventud, ayudarnos con nuestras limitaciones y descubrirnos la parte más humana de la práctica clínica y la investigación.En el futuro, ojalá tenga la suerte de poder seguir contando con la colaboración de todos estos magníficos científicos y espero ...

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Differentiation between aberrant ventricular conduction and ventricular ectopy in atrial fibrillation using RR interval scattergram.

Abstract: We conclude that the RR interval scattergram makes it possible to differentiate between aberrant ventricular conduction and ventricular ectopy in atrial fibrillation, and thus, it is a useful noninvasive clinical tool.

Cited by 26 publications

References 14 publications

Effect of induced chronic atrial fibrillation on exercise performance in Standardbred trotters

Effect of induced chronic atrial fibrillation on exercise performance in Standardbred trotters

Ventricular response during lungeing exercise in horses with lone atrial fibrillation

Characterization and Modeling of Atrioventricular Conduction during Atrial Fibrillation

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