The signal-averaged electrocardiogram before and after electrical cardioversion of persistent atrial fibrillation-implications of the sudden change in rhythm.

Gottfridsson, Christer,1958Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine (author)

BACKGROUND: Atrial fibrillation (AF), electrical cardioversion (direct current, or DC) shock energy, and a sudden change to sinus rhythm (SR) might all influence the interpretation of the signal-averaged electrocardiogram (SAECG) as risk markers of ventricular tachyarrhythmia. METHODS: The SAECG was recorded in 82 patients with persistent AF before and 2 hours after DC and analyzed for ventricular late potentials (LPs) and spectral turbulence. RESULTS: Sixty-nine patients (84%) obtained SR. Their mean (SD) heart rate decreased by 22 (20) beats/min, and the QTcF interval was significantly prolonged, 17 (38) milliseconds, as was the filtered QRS duration, 1.1 (4.7) milliseconds (40 Hz). The proportion of LP positivity (20%) did not change with the change in rhythm. Eight of 60 spectral turbulence-negative patients before DC became positive after DC (P = .01). The change in SAECG variables did not correlate significantly with the amount of energy delivered at DC. CONCLUSION: The LP analysis provided similar results in AF and SR, whereas the spectral turbulence analysis was more abnormal in SR. The electrical shock itself did not seem to explain this phenomenon.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine hsv//eng
Atrial fibrillation; Electrocardiography; Signal-averaged ECG; Late potentials; Spectral turbulence; QT interval

Karlsson, Thomas,1956Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xkarth (author)
Edvardsson, Nils,1942Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xedvni (author)
Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin (creator_code:org_t)

By the author/editor: Gottfridsson, Ch ...; Karlsson, Thomas ...; Edvardsson, Nils ...

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