| 1. |
- Corino, Valentina D. A., et al.
(författare)
-
Improved Time-Frequency Analysis of Atrial Fibrillation Signals Using Spectral Modeling
- 2008
-
Ingår i: IEEE Transactions on Biomedical Engineering. - 1558-2531. ; 55:12, s. 2723-2730
-
Tidskriftsartikel (refereegranskat)abstract
- In patients with atrial fibrillation (AF), the fibrillatory frequency trend and the time-dependent spectral characteristics can be investigated using a spectral profile technique. The spectral profile is updated by fitting each short-time spectrum. The aim of this study is to develop model-based means for stricter control on the update of the spectral profile. A spectral model defined by a superposition of Gaussian functions is suggested for describing the fundamental and harmonics of the atrial waves during AF, thereby accounting for basic characteristics of the typical AF spectrum. The model parameters are obtained from weighted least squares fitting of the model to the observed spectrum. The method was tested on simulated signals as well as on 48 ECG recordings from 15 patients with persistent AF. Using simulated signals, we assessed the accuracy in terms of magnitude and width or the spectral peaks. For SNR = 0 dB, the maximum normalized error was less than 0.2 when estimating magnitude of both the fundamental and the harmonics, whereas it was less than 0.15 for the fundamental and 0.7 for the harmonics with respect to the estimation of the width. We observed a marked Improvement while tracking the main fibrillatory frequency as the error was reduced by more than 50% In comparison with the original method. Analyzing ECGs, reliable spectral profiles were obtained In all recordings, even In those cases (5/48) that were not well characterized by the original method.
|
|
| 2. |
- Husser, Oliver, et al.
(författare)
-
Exercise testing for non-invasive assessment of atrial electrophysiological properties in patients with persistent atrial fibrillation
- 2007
-
Ingår i: Europace. - : Oxford University Press (OUP). - 1532-2092. ; 9:8, s. 627-632
-
Tidskriftsartikel (refereegranskat)abstract
- Aims Experimental studies suggest that the autonomic nervous system modulates atrial refractoriness and conduction velocity in atrial. fibrillation (AF). These modulatory effects are, however, difficult to assess in the clinical setting. This study sought to non-invasively characterize in patients with persistent AF, the influence of autonomic modulation induced by exercise on atrial fibrillatory rate as marker of atrial refractoriness and to identify clinical and electrocardiographic predictors of atrial rate response. Methods and results In 24 patients (16 mates, mean age 60 +/- 13 years) with persistent AF (16 +/- 25 months), continuous ECGs were recorded during bicycle exercise testing. Fibrillatory rate (in fibrillations per minute, fpm) was assessed at baseline and immediately after termination of exercise with spatiotemporal QRST cancellation and time-frequency analysis. Ventricular response was characterized by time-domain HRV indices. Exercise had no influence on mean fibrillatory rate (409 +/- 42 vs. 414 +/- 43 fpm, P = NS). Seven patients responded to exercise with an increase in fibrillatory rate (26 10 fpm, P < 0.001 and three with a decrease (-21 +/- 8 fpm, P < 0.001), while the remaining 14 patients did not show a response. Responders' HRV indices changed in response to exercise similarly to that of non-responders. Their baseline fibrillatory rate was, however, lower than that of non-responders (387 +/- 18 vs. 425 +/- 48 fpm, P = 0.028). No other clinical or echocardiographic variable was associated with fibrillatory rate response. Twelve weeks after cardioverson, responders were more likely to remain in sinus rhythm than non-responders (88 vs. 46 %, P = 0.04). Conclusions Exercise-induced autonomic activation produces changes in atrial. etectrophysiological properties that can be detected by time-frequency analysis. Higher baseline fibrillatory rates are associated with an impaired atrial response to exercise that suggests advanced electrical remodelling and reduced sensitivity to autonomic stimuli.
|
|
