Non-invasive assessment of the atrial cycle length during atrial fibrillation in man: introducing, validating and illustrating a new ECG method

Holm, Magnus; Pehrson, Steen; Ingemansson, Max; Sörnmo, Leif; Johansson, Rolf; Sandhall, Lennart; Sunemark, Max; Smideberg, Birgit; Olsson, Christian; Olsson, S. Bertil

doi:10.1016/s0008-6363(97)00289-7

Cited by 236 publications

(237 citation statements)

References 27 publications

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“…7 A new method for noninvasive assessment of the human AF cycle length using surface ECG with spectral analysis has been reported. 8,9 The frequency characteristics of fibrillation waves from the surface ECG are analyzed using QRST subtraction methods and a significant correlation between the frequency content of the surface ECG and the intracardiac electrograms has been observed during AF. In drug-induced termination, the mean FCL increased after drug administration, but the CV of the FCL was unchanged.…”

Section: Spectral Analysis Of Afmentioning

confidence: 99%

Role of Fibrillation Cycle Length in Spontaneous and Drug-Induced Termination of Human Atrial Fibrillation-Spectral Analysis of Fibrillation Waves From Surface Electrocardiogram-

Fujiki

Sakabe

Nishida

et al. 2003

Circ J

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persistently rapid rate of atrial excitation produces a progressive shortening of the atrial effective refractory period and promotes the perpetuation of atrial fibrillation (AF); 1,2 however, most paroxysmal AF terminates spontaneously within a few days despite the presence of atrial remodeling. Termination of human AF with class I antiarrhythmic drugs is preceded by an increase in fibrillation cycle length (FCL), and a failure to increase the FCL correlates with a failure to terminate the AF with medication. 3 In canine models of AF, the mapping data suggest that the increase in FCL induced by antiarrhythmic drugs may relate to fusion of wavelets, an increase in the size of reentry circuits, a decrease in circuit number and finally, termination of AF. 4 Compared with drug-induced termination, the mechanism of spontaneous termination of human AF is still unclear. It is difficult to obtain intracardiac recordings just prior to spontaneous termination of paroxysmal AF for analysis of the fibrillation waves because spontaneous

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Section: Spectral Analysis Of Afmentioning

confidence: 99%

Role of Fibrillation Cycle Length in Spontaneous and Drug-Induced Termination of Human Atrial Fibrillation-Spectral Analysis of Fibrillation Waves From Surface Electrocardiogram-

Fujiki

Sakabe

Nishida

et al. 2003

Circ J

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“…The size of the left atrium is to date the main parameter to support diagnosis and decisions for treatment options [5,6], although its role in predicting outcome after a cardioversion is discussed controversially [7,8]. Further classifications are based on the averaging of P waves [9,10], on the amplitude of the fibrillatory waves in the surface electrocardiogram (ECG) [11], or on the morphology of the intra-atrial ECG [12].…”

Section: Introductionmentioning

confidence: 99%

Exponential Distribution of Long Heart Beat Intervals During Atrial Fibrillation and Their Relevance for White Noise Behaviour in Power Spectrum

et al. 2006

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The statistical properties of heart beat intervals of 130 long-term surface electrocardiogram recordings during atrial fibrillation (AF) are investigated. We find that the distribution of interbeat intervals exhibits a characteristic exponential tail, which is absent during sinus rhythm, as tested in a corresponding control study with 72 healthy persons. The rate γ of the exponential decay lies in the range 3-12 Hz and shows diurnal variations. It equals, up to statistical uncertainties, the level of the previously uncovered white noise part of the power spectrum, which is also characteristic for AF. The overall statistical features can be described by decomposing the intervals into two statistically independent times, where the first one is associated with a correlated process with 1/ f noise characteristics, while the second one belongs to an uncorrelated process and is responsible for the exponential tail. It is suggested to use γ as a further parameter for a better classification of AF and for the medical diagnosis. The relevance of the findings with respect to a general understanding of AF is discussed.

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“…21) Holma, et al hypothesized noninvasive assessment of the atrial cycle length during atrial fibrillation in man. 22) They proposed a new method named 'Frequency analysis of fibrillatory ECG (FAF-ECG)' originally developed by Slocum, et al 23) In brief, (1) an average of the time-aligned QRST complexes was created and subtracted from the original ECG signal, and (2) a frequency spectrum of the residual ECG signal was estimated using FFT. Of the 12 surface ECG leads, the precordial lead V 1 was chosen for the frequency analysis.…”

Section: Discussionmentioning

confidence: 99%

“…This method has, however, some important limitations as pointed out by Holma. 22) A reliable and accurate identification of the atrial spectral component is dependent on suppression of the QRST complexes.…”

Section: Discussionmentioning

confidence: 99%

Body Surface Two-Dimensional Spectral Map of Atrial Fibrillation Using Vector-Projected 187 Channel Electrocardiography

et al. 2012

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SummaryAtrial cycle length during atrial fibrillation and flutter waves may be correlated with atrial refractoriness and organization. The nature of the frequency by spectral analysis may reflect a profile of atrial cycle length. In this study, we developed a novel body surface 2-dimensional spectral map during fibrillation using vector-projected 187 channel ECG (187ch VP-ECG).The study consisted of 28 patients (24 with atrial fibrillation (AFIB) and 4 atrial flutter (AFL) with valvular heart disease). We performed spectral analysis by maximum entropy modeling (MEM) in 4 second nonaveraged 187ch electrical current waves by 187ch VP-ECG. Body surface spectral features were displayed according to the frequency and power magnitude components. We verified the accuracy of the spectral features by a 64ch magnetocardiography (MCG).The average dominant frequency in AFL by 187ch VP-ECG was lower than those in AFIB (4.6 ± 0.9 Hz in AFL, 7.2 ± 0.9 Hz in AFIB, P < 0.01). Comparison of average dominant frequency between 187ch VP-ECG and 64 ch MCG demonstrated good agreement (y = 0.86x+0.84, r 2 = 0.89, P < 0.0001). Body surface 2-dimensional spectral features demonstrated homogenous spectrum patterns in AFL, and in-homogenous spectrum patterns in AFIB.In conclusion, novel body surface spectral mapping using 187ch VP-ECG may represent a 2-dimensional spectral feature that may be related to atrial refractoriness and organization. (Int Heart J 2012; 53: 5-10) Key words: Atrial fibrillation, Body surface map, Vector projection, Spectral analysis, Magnetocardiography A trial fibrillation (AFIB) was reported to be an independent risk factor for stroke in the Framingham Study. In patients with coronary heart disease or cardiac failure, atrial fibrillation doubled the stroke risk in men and trebled the risk in women.1,2) Left atrial myocardial extension on to pulmonary veins in humans by anatomic observation might be relevant for atrial arrhythmias.3) Certain cases of AFIB may be maintained by small re-entrant rotors that result in a hierarchical distribution of frequencies throughout the atria.4,5) Recent advances in interventional catheter ablation and surgical pulmonary vein isolation, radical treatments have been applied in patients with atrial flutter (AFL) and AFIB. 6,7) Holma, et al reported noninvasive assessment of the atrial cycle length during atrial fibrillation in humans. 8) Sanders, et al reported spectral analysis and frequency mapping identify localized sites of high-frequency activity during AFIB in humans with different distributions in paroxysmal and permanent AFIB.9,10) Determination of the features of cycle length of excitation of atrial fibrillation is important for a therapeutic strategy.Magnetocardiography (MCG) has the potential to detect 3-dimensional (3D) electrical current density and electrical repolarization phenomena because the magnetic field is unaffected by the shape of the lungs and the torso.11,12) Previously, we reported a 3D spectral map of the atrial fibrillation generated by 64ch cardiomagneti...

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Non-invasive assessment of the atrial cycle length during atrial fibrillation in man: introducing, validating and illustrating a new ECG method

Abstract: We conclude that this new non-invasive method, named 'Frequency Analysis of Fibrillatory ECG' (FAF-ECG), is capable of assessing both the magnitude and the dynamics of the atrial fibrillation cycle length in man.

Cited by 236 publications

References 27 publications

Role of Fibrillation Cycle Length in Spontaneous and Drug-Induced Termination of Human Atrial Fibrillation-Spectral Analysis of Fibrillation Waves From Surface Electrocardiogram-

Role of Fibrillation Cycle Length in Spontaneous and Drug-Induced Termination of Human Atrial Fibrillation-Spectral Analysis of Fibrillation Waves From Surface Electrocardiogram-

Exponential Distribution of Long Heart Beat Intervals During Atrial Fibrillation and Their Relevance for White Noise Behaviour in Power Spectrum

Body Surface Two-Dimensional Spectral Map of Atrial Fibrillation Using Vector-Projected 187 Channel Electrocardiography

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