Frequency Analysis of Atrial Fibrillation Predicts Success for Low Energy Intracardiac Cardioversion

JD Diaz, OJ Escalona, JMCC Anderson, B Glover, AAJ Adgey

Research output: Chapter in Book/Report/Conference proceedingConference contribution

1 Citation (Scopus)

Abstract

The aim of this study was to evaluate the relation between atrial fibrillatory frequency (AFF) and the probability of successful internal cardioversion of atrial fibrillation (AF). Thirty consecutive patients suggested for DC cardioversion at the Royal Victoria Hospital in Belfast, were included in the study. Two catheters were positioned in the right atrial appendage (RAA) and the coronary sinus (CS), for delivering a biphasic shock waveform, 6/6 msec, synchronized with the R-wave on the ECG signal. The atrial fibrillatory activity was derived from 60 seconds of surface ECG from the defibrillator pads, prior to shock delivery, by bandpass filtering and ventricular activity (QRST) cancellation. QRST complexes subtraction was implemented by means of a template matching and signal averaging algorithm. FFT was applied to the residual atrial fibrillatory signal. Atrial fibrillatory frequency was estimated from the dominant frequency in the 3-12Hz band of the power spectrum. Eighteen patients were successfully cardioverted using a voltage step up protocol beginning from 50V up to 300V (biphasic pulse amplitude). Twelve of the cases were not successfully cardioverted to sinus rhythm. The AFF was 5.42 +/- 1.03 Hz (within the range of 3.69 - 7.38 Hz) in patients successfully cardioverted vs. 6.5 +/- 0.68 Hz (within the range of 5.38-7.56 Hz) in patients which failed cardioversion, P < 0.004. AFF was < 6.26 Hz in 15 of the 18 patients with successful cardioversion. AF cardioversion was predicted with a specificity of 83.33% in the best cases, and with an acceptable sensitivity of 75%. Also, there was a positive correlation (rho = 0.624 and P < 0.01) between the minimal defibrillation energy and the fibrillatory frequency in cardioverted patients. In conclusion, calculated AFF from the surface ECG, may predict the success of internal low energy cardioversion of patients with atrial fibrillation.
LanguageEnglish
Title of host publicationUnknown Host Publication
Place of PublicationHEIDELBERGER PLATZ 3, D-14197 BERLIN, GERMANY
Pages1017-1020
Number of pages4
Publication statusPublished - 2007
EventWORLD CONGRESS ON MEDICAL PHYSICS AND BIOMEDICAL ENGINEERING 2006, VOL 14, PTS 1-6 -
Duration: 1 Jan 2007 → …

Publication series

NameIFMBE Proceedings

Conference

ConferenceWORLD CONGRESS ON MEDICAL PHYSICS AND BIOMEDICAL ENGINEERING 2006, VOL 14, PTS 1-6
Period1/01/07 → …

Fingerprint

Electric Countershock
Atrial Fibrillation
Electrocardiography
Shock
Atrial Appendage
Defibrillators
Coronary Sinus
Victoria
Pulse
Catheters

Keywords

  • Atrial Fibrillation
  • Cardioversion
  • Defibrillation
  • Fibrillation Frequency
  • QRS Cancellation.

Cite this

Diaz, JD., Escalona, OJ., Anderson, JMCC., Glover, B., & Adgey, AAJ. (2007). Frequency Analysis of Atrial Fibrillation Predicts Success for Low Energy Intracardiac Cardioversion. In Unknown Host Publication (pp. 1017-1020). (IFMBE Proceedings). HEIDELBERGER PLATZ 3, D-14197 BERLIN, GERMANY.
Diaz, JD ; Escalona, OJ ; Anderson, JMCC ; Glover, B ; Adgey, AAJ. / Frequency Analysis of Atrial Fibrillation Predicts Success for Low Energy Intracardiac Cardioversion. Unknown Host Publication. HEIDELBERGER PLATZ 3, D-14197 BERLIN, GERMANY, 2007. pp. 1017-1020 (IFMBE Proceedings).
@inproceedings{f0b72da1cc1f41f886e0c572b8440a6b,
title = "Frequency Analysis of Atrial Fibrillation Predicts Success for Low Energy Intracardiac Cardioversion",
abstract = "The aim of this study was to evaluate the relation between atrial fibrillatory frequency (AFF) and the probability of successful internal cardioversion of atrial fibrillation (AF). Thirty consecutive patients suggested for DC cardioversion at the Royal Victoria Hospital in Belfast, were included in the study. Two catheters were positioned in the right atrial appendage (RAA) and the coronary sinus (CS), for delivering a biphasic shock waveform, 6/6 msec, synchronized with the R-wave on the ECG signal. The atrial fibrillatory activity was derived from 60 seconds of surface ECG from the defibrillator pads, prior to shock delivery, by bandpass filtering and ventricular activity (QRST) cancellation. QRST complexes subtraction was implemented by means of a template matching and signal averaging algorithm. FFT was applied to the residual atrial fibrillatory signal. Atrial fibrillatory frequency was estimated from the dominant frequency in the 3-12Hz band of the power spectrum. Eighteen patients were successfully cardioverted using a voltage step up protocol beginning from 50V up to 300V (biphasic pulse amplitude). Twelve of the cases were not successfully cardioverted to sinus rhythm. The AFF was 5.42 +/- 1.03 Hz (within the range of 3.69 - 7.38 Hz) in patients successfully cardioverted vs. 6.5 +/- 0.68 Hz (within the range of 5.38-7.56 Hz) in patients which failed cardioversion, P < 0.004. AFF was < 6.26 Hz in 15 of the 18 patients with successful cardioversion. AF cardioversion was predicted with a specificity of 83.33{\%} in the best cases, and with an acceptable sensitivity of 75{\%}. Also, there was a positive correlation (rho = 0.624 and P < 0.01) between the minimal defibrillation energy and the fibrillatory frequency in cardioverted patients. In conclusion, calculated AFF from the surface ECG, may predict the success of internal low energy cardioversion of patients with atrial fibrillation.",
keywords = "Atrial Fibrillation, Cardioversion, Defibrillation, Fibrillation Frequency, QRS Cancellation.",
author = "JD Diaz and OJ Escalona and JMCC Anderson and B Glover and AAJ Adgey",
note = "World Congress on Medical Physics and Biomedical Engineering, Seoul, SOUTH KOREA, AUG 27-SEP 01, 2006",
year = "2007",
language = "English",
series = "IFMBE Proceedings",
pages = "1017--1020",
booktitle = "Unknown Host Publication",

}

Diaz, JD, Escalona, OJ, Anderson, JMCC, Glover, B & Adgey, AAJ 2007, Frequency Analysis of Atrial Fibrillation Predicts Success for Low Energy Intracardiac Cardioversion. in Unknown Host Publication. IFMBE Proceedings, HEIDELBERGER PLATZ 3, D-14197 BERLIN, GERMANY, pp. 1017-1020, WORLD CONGRESS ON MEDICAL PHYSICS AND BIOMEDICAL ENGINEERING 2006, VOL 14, PTS 1-6, 1/01/07.

Frequency Analysis of Atrial Fibrillation Predicts Success for Low Energy Intracardiac Cardioversion. / Diaz, JD; Escalona, OJ; Anderson, JMCC; Glover, B; Adgey, AAJ.

Unknown Host Publication. HEIDELBERGER PLATZ 3, D-14197 BERLIN, GERMANY, 2007. p. 1017-1020 (IFMBE Proceedings).

Research output: Chapter in Book/Report/Conference proceedingConference contribution

TY - GEN

T1 - Frequency Analysis of Atrial Fibrillation Predicts Success for Low Energy Intracardiac Cardioversion

AU - Diaz, JD

AU - Escalona, OJ

AU - Anderson, JMCC

AU - Glover, B

AU - Adgey, AAJ

N1 - World Congress on Medical Physics and Biomedical Engineering, Seoul, SOUTH KOREA, AUG 27-SEP 01, 2006

PY - 2007

Y1 - 2007

N2 - The aim of this study was to evaluate the relation between atrial fibrillatory frequency (AFF) and the probability of successful internal cardioversion of atrial fibrillation (AF). Thirty consecutive patients suggested for DC cardioversion at the Royal Victoria Hospital in Belfast, were included in the study. Two catheters were positioned in the right atrial appendage (RAA) and the coronary sinus (CS), for delivering a biphasic shock waveform, 6/6 msec, synchronized with the R-wave on the ECG signal. The atrial fibrillatory activity was derived from 60 seconds of surface ECG from the defibrillator pads, prior to shock delivery, by bandpass filtering and ventricular activity (QRST) cancellation. QRST complexes subtraction was implemented by means of a template matching and signal averaging algorithm. FFT was applied to the residual atrial fibrillatory signal. Atrial fibrillatory frequency was estimated from the dominant frequency in the 3-12Hz band of the power spectrum. Eighteen patients were successfully cardioverted using a voltage step up protocol beginning from 50V up to 300V (biphasic pulse amplitude). Twelve of the cases were not successfully cardioverted to sinus rhythm. The AFF was 5.42 +/- 1.03 Hz (within the range of 3.69 - 7.38 Hz) in patients successfully cardioverted vs. 6.5 +/- 0.68 Hz (within the range of 5.38-7.56 Hz) in patients which failed cardioversion, P < 0.004. AFF was < 6.26 Hz in 15 of the 18 patients with successful cardioversion. AF cardioversion was predicted with a specificity of 83.33% in the best cases, and with an acceptable sensitivity of 75%. Also, there was a positive correlation (rho = 0.624 and P < 0.01) between the minimal defibrillation energy and the fibrillatory frequency in cardioverted patients. In conclusion, calculated AFF from the surface ECG, may predict the success of internal low energy cardioversion of patients with atrial fibrillation.

AB - The aim of this study was to evaluate the relation between atrial fibrillatory frequency (AFF) and the probability of successful internal cardioversion of atrial fibrillation (AF). Thirty consecutive patients suggested for DC cardioversion at the Royal Victoria Hospital in Belfast, were included in the study. Two catheters were positioned in the right atrial appendage (RAA) and the coronary sinus (CS), for delivering a biphasic shock waveform, 6/6 msec, synchronized with the R-wave on the ECG signal. The atrial fibrillatory activity was derived from 60 seconds of surface ECG from the defibrillator pads, prior to shock delivery, by bandpass filtering and ventricular activity (QRST) cancellation. QRST complexes subtraction was implemented by means of a template matching and signal averaging algorithm. FFT was applied to the residual atrial fibrillatory signal. Atrial fibrillatory frequency was estimated from the dominant frequency in the 3-12Hz band of the power spectrum. Eighteen patients were successfully cardioverted using a voltage step up protocol beginning from 50V up to 300V (biphasic pulse amplitude). Twelve of the cases were not successfully cardioverted to sinus rhythm. The AFF was 5.42 +/- 1.03 Hz (within the range of 3.69 - 7.38 Hz) in patients successfully cardioverted vs. 6.5 +/- 0.68 Hz (within the range of 5.38-7.56 Hz) in patients which failed cardioversion, P < 0.004. AFF was < 6.26 Hz in 15 of the 18 patients with successful cardioversion. AF cardioversion was predicted with a specificity of 83.33% in the best cases, and with an acceptable sensitivity of 75%. Also, there was a positive correlation (rho = 0.624 and P < 0.01) between the minimal defibrillation energy and the fibrillatory frequency in cardioverted patients. In conclusion, calculated AFF from the surface ECG, may predict the success of internal low energy cardioversion of patients with atrial fibrillation.

KW - Atrial Fibrillation

KW - Cardioversion

KW - Defibrillation

KW - Fibrillation Frequency

KW - QRS Cancellation.

M3 - Conference contribution

T3 - IFMBE Proceedings

SP - 1017

EP - 1020

BT - Unknown Host Publication

CY - HEIDELBERGER PLATZ 3, D-14197 BERLIN, GERMANY

ER -

Diaz JD, Escalona OJ, Anderson JMCC, Glover B, Adgey AAJ. Frequency Analysis of Atrial Fibrillation Predicts Success for Low Energy Intracardiac Cardioversion. In Unknown Host Publication. HEIDELBERGER PLATZ 3, D-14197 BERLIN, GERMANY. 2007. p. 1017-1020. (IFMBE Proceedings).