Abrupt changes in fibrillatory wave characteristics at the termination of paroxysmal atrial fibrillation in humans

Simona Petrutiu, Alan Varteres Sahakian, Steven Swiryn*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

63 Scopus citations

Abstract

Aims: We investigated the process of spontaneous termination of atrial fibrillation (AF) to determine its time course from the surface ECG. Methods and results: We studied fibrillatory waves in Holter recordings of paroxysmal and sustained AF. Following QRS-T cancellation dominant frequencies (DFs) were computed and the relationship of DF to termination was scrutinized. For 57 episodes of paroxysmal AF (PAF) in 24 patients, DF ranged from 4.4 to 6.5 Hz (5.2 ± 0.4 Hz) compared to 5.8 to 7.4 Hz (6.6 ± 0.6 Hz) for sustained AF recordings. Comparison of the atrial frequency of the ultimate to the penultimate second demonstrated a drop in frequency in 51 of 57 episodes, P < 0.00001. No comparable change was seen at longer time periods. Moments of comparably low frequency without termination were only occasionally seen in patients with PAF but not in patients with sustained AF. Conclusion: Low frequency fibrillation was found to be much more likely to terminate. Frequency changes preceding spontaneous termination were abrupt, in contrast to the gradual frequency drop reported with drug-induced termination. The analysis of fibrillatory wave characteristics and their change over time might be used to target specific moments for pacing therapy in patients with AF.

Original languageEnglish (US)
Pages (from-to)466-470
Number of pages5
JournalEuropace
Volume9
Issue number7
DOIs
StatePublished - Jul 1 2007

Keywords

  • Atrial fibrillation
  • Cancellation
  • Spectral analysis
  • Termination

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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