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| Content Provider | frontiers |
|---|---|
| Author | Karlsson, Mattias Wallman, Mikael Platonov, Pyotr G. Ulimoen, Sara R. Sandberg, Frida |
| Abstract | The heart rate during atrial fibrillation (AF) is highly dependent on the conduction properties of the atrioventricular (AV) node. These properties can be affected using beta-blockers or calcium channel blockers, mainly chosen empirically. Characterization of individual AV-nodal conduction could assist in personalized treatment selection during AF. Individual AV nodal refractory periods and conduction delays were characterized based on 24-hour ambulatory ECGs from 60 patients with permanent AF. This was done by estimating model parameters from a previously created mathematical network model of the AV node using a problem-specific genetic algorithm. Based on the estimated model parameters, the circadian variation and its drug-dependent difference between treatment with two beta-blockers and two calcium blockers were quantified on a population level by means of cosinor analysis using a linear mixed-effect approach. The mixed-effects analysis indicated increased refractoriness relative to baseline for all drugs. An additional decrease in circadian variation for parameters representing conduction delay was observed for the beta-blockers. This indicates that the two drug types have quantifiable differences in their effects on AV-nodal conduction properties. These differences could be important in treatment outcome, and thus quantifying them could assist in treatment selection. |
| ISSN | 1664042X |
| DOI | 10.3389/fphys.2022.976526 |
| Volume Number | 13 |
| Journal | Frontiers in Physiology |
| Language | English |
| Publisher Date | 2022-10-04 |
| Access Restriction | Open |
| Subject Keyword | Mathematical modeling Atrioventricular Node Genetic Algorithm Mixed effect modeling Circadian variation ECG Atrial Fibrillation Rate control drugs |
| Content Type | Text |
| Resource Type | Article |
| Subject | Physiology Physiology (medical) |
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