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.
Original 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 → …

Keywords

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

Fingerprint Dive into the research topics of 'Frequency Analysis of Atrial Fibrillation Predicts Success for Low Energy Intracardiac Cardioversion'. Together they form a unique fingerprint.

  • 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.