| 1. |
- Holmqvist, Fredrik, et al.
(författare)
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Study of ECG-derived atrial fibrillatory rate for prediction of the outcome of cardioversion of short duration atrial fibrillation (CASAF)
- 2023
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Ingår i: Journal of Electrocardiology. - 0022-0736. ; 81, s. 20-22
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The present study aimed at testing the hypothesis that atrial fibrillatory rate (AFR) is predictive of sinus rhythm maintenance after electrical cardioversion. Methods and results: The study comprised 32 patients admitted for cardioversion of atrial fibrillation of short duration (mean duration 3.8 ± 7.7 days). AFR was estimated using frequency power spectrum analysis of QRST-cancelled ECG. At six-weeks follow-up 22% of the patients had relapsed to AF. The pre-cardioversion mean AFR of those was 332 ± 64 fpm compared to 378 ± 59 fpm among patients maintaining sinus rhythm (p = 0.12). Conclusion: AFR was not predictive of sinus rhythm maintenance in patients of short duration AF undergoing cardioversion. This is in stark contrast with the earlier reported findings. Clinical trial registration: NCT02112318 (http://www.clinicaltrials.gov).
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| 2. |
- Platonov, Pyotr, et al.
(författare)
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Atrial fibrillatory rate in the clinical context: natural course and prediction of intervention outcome.
- 2014
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Ingår i: Europace. - : Oxford University Press (OUP). - 1532-2092 .- 1099-5129. ; 16 Suppl 4, s. 110-119
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Tidskriftsartikel (refereegranskat)abstract
- Shortening of atrial refractory period during atrial fibrillation has been considered a hallmark of atrial electrical remodelling. The atrial fibrillatory cycle length, which is intimately related to the atrial fibrillatory rate (AFR), is generally accepted as a surrogate marker for local refractoriness. The value of using AFR to monitor the progress of atrial ablation therapy has been demonstrated and gradual slowing of AFR has consistently been observed to precede arrhythmia termination during paroxysmal or permanent atrial fibrillation ablation. Today, AFR is the key characteristic of the fibrillatory process, repeatedly validated against intracardiac recordings and extensively studied in clinical contexts. This paper provides an overview of clinical data accumulated since the method was introduced in 1998, and to present the current state of knowledge regarding ECG-derived AFR: its time course and dynamics, clinical factors affecting AFR, and available evidence of its value in the clinical context. We conclude that AFR is a promising, easily available AF characteristic that can be derived from the conventional surface ECG. It is clearly a useful tool for monitoring drug effects. Reference values for predicting intervention effect, however, are likely to be population- and context-specific and related to age, clinical types of atrial fibrillation, as well as to presence and advancement of underlying structural heart disease. Prospective studies in homogeneous patient populations are still needed to establish the clinical value of AFR.
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| 3. |
- Seifert, Mariam B., et al.
(författare)
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Genetic variants on chromosomes 7p31 and 12p12 are associated with abnormal atrial electrical activation in patients with early-onset lone atrial fibrillation
- 2019
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Ingår i: Annals of Noninvasive Electrocardiology. - : Wiley. - 1082-720X .- 1542-474X. ; 24:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Abnormal P-wave morphology (PWM) has been associated with a history of atrial fibrillation (AF) in earlier studies. Although lone AF is believed to have substantial genetic basis, studies on associations between single nucleotide polymorphisms (SNP) linked to lone AF and PWM have not been reported. We aimed to assess whether SNPs previously associated with lone AF (rs2200733, rs13376333, rs3807989, and rs11047543) are also linked to P-wave abnormalities. Methods: Four SNPs were studied in 176 unrelated individuals with early-onset lone AF (age at onset <50 years), median age 38 years (19–63 years), 149 men. Using sinus rhythm ECG, orthogonal PWM was classified as Type 1—positive in leads X and Y and negative in lead Z, Type 2—positive in leads X and Y and biphasic (−/+) in lead Z, Type 3—positive in lead X and biphasic in lead Y (+/−), and the remaining as atypical. Results: Two SNPs were found to be significantly associated with altered P-wave morphology distribution: rs3807989 near the gene CAV1/CAV2 and rs11047543 near the gene SOX5. Both SNPs were associated with a higher risk of non-Type 1 P-wave morphology (rs3807989: OR = 4.8, 95% CI = 2.3–10.2, p < 0.001; rs11047543: OR = 4.7, 95% CI = 1.1–20.5, p = 0.04). No association was observed for rs2200733 and rs13376333. Conclusion: In this study, the two variants rs3807989 and rs11047543, previously associated with PR interval and lone AF, were associated with altered P-wave morphology distribution in patients with early-onset lone AF. These findings suggest that common genetic variants may modify atrial conduction properties.
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