Intracardiac impedance response during acute AF internal cardioversion using novel rectilinear and capacitor-discharge waveforms.

AS Rababah, SJ Walsh, G Manoharan, PR Walsh, OJ Escalona

Research output: Contribution to journalArticle

Abstract

Intracardiac impedance (ICI) is a major determinant of success during internal cardioversion of atrial fibrillation (AF). However, there have been few studies that have examined the dynamic behaviour of atrial impedance during internal cardioversion in relation to clinical outcome. In this study, voltage and current waveforms captured during internal cardioversion of acute AF in ovine models using novel radiofrequency (RF) generated low-tilt rectilinear and conventional capacitor-discharge based shock waveforms were retrospectively analysed using a digital signal processing algorithm to investigate the dynamic behaviour of atrial impedance during cardioversion. The algorithm was specifically designed to facilitate the simultaneous analysis of multiple impedance parameters, including: mean intracardiac impedance (Z M), intracardiac impedance variance (ICIV) and impedance amplitude spectrum area (IAMSA) for each cardioversion event. A significant reduction in ICI was observed when comparing two successive shocks of increasing energy where cardioversion outcome was successful. In addition, ICIV and IAMSA variables were found to inversely correlate to the magnitude of energy delivered; with a stronger correlation found to the former parameter. In conclusion, ICIV and IAMSA have been evidenced as two key dynamic intracardiac impedance variables that may prove useful in better understanding of the cardioversion process and that could potentially act as prognostic markers with respect to clinical outcome.
LanguageEnglish
Pages1129-1145
JournalPhysiological Measurement
Volume37
Issue number7
Early online date22 Jun 2016
DOIs
Publication statusE-pub ahead of print - 22 Jun 2016

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Electric Countershock
Electric Impedance
Atrial Fibrillation
Capacitors
Digital signal processing
Electric potential
Shock
Computer-Assisted Signal Processing
Sheep

Keywords

  • Atrial fibrillation
  • AF
  • acute AF model
  • internal cardioversion
  • intracardiac impedance variance
  • ICIV
  • impedance amplitude spectrum area
  • IAMSA
  • defibrillation.

Cite this

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title = "Intracardiac impedance response during acute AF internal cardioversion using novel rectilinear and capacitor-discharge waveforms.",
abstract = "Intracardiac impedance (ICI) is a major determinant of success during internal cardioversion of atrial fibrillation (AF). However, there have been few studies that have examined the dynamic behaviour of atrial impedance during internal cardioversion in relation to clinical outcome. In this study, voltage and current waveforms captured during internal cardioversion of acute AF in ovine models using novel radiofrequency (RF) generated low-tilt rectilinear and conventional capacitor-discharge based shock waveforms were retrospectively analysed using a digital signal processing algorithm to investigate the dynamic behaviour of atrial impedance during cardioversion. The algorithm was specifically designed to facilitate the simultaneous analysis of multiple impedance parameters, including: mean intracardiac impedance (Z M), intracardiac impedance variance (ICIV) and impedance amplitude spectrum area (IAMSA) for each cardioversion event. A significant reduction in ICI was observed when comparing two successive shocks of increasing energy where cardioversion outcome was successful. In addition, ICIV and IAMSA variables were found to inversely correlate to the magnitude of energy delivered; with a stronger correlation found to the former parameter. In conclusion, ICIV and IAMSA have been evidenced as two key dynamic intracardiac impedance variables that may prove useful in better understanding of the cardioversion process and that could potentially act as prognostic markers with respect to clinical outcome.",
keywords = "Atrial fibrillation, AF, acute AF model, internal cardioversion, intracardiac impedance variance, ICIV, impedance amplitude spectrum area, IAMSA, defibrillation.",
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Intracardiac impedance response during acute AF internal cardioversion using novel rectilinear and capacitor-discharge waveforms. / Rababah, AS; Walsh, SJ; Manoharan, G; Walsh, PR; Escalona, OJ.

In: Physiological Measurement, Vol. 37, No. 7, 22.06.2016, p. 1129-1145.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intracardiac impedance response during acute AF internal cardioversion using novel rectilinear and capacitor-discharge waveforms.

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AU - Walsh, SJ

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AU - Walsh, PR

AU - Escalona, OJ

PY - 2016/6/22

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