NDLI: The effect of internal DC shocks on the atrial fibrillation frequency

Content Provider	IEEE Xplore Digital Library
Author	Diaz, J. Castro, N. Escalona, O. Anderson, J.M. Glover, B.M. Adgey, J.A.
Copyright Year	2007
Description	Author affiliation: Univ. Simon Bolivar, Caracas (Diaz, J.; Castro, N.)
Abstract	The objective of this study, was to investigate the effect of internal DC shocks on the atrial fibrillation frequency (AFF). AFF has previously been shown to predict the success and energy requirements in patients undergoing internal cardioversion (IC) of atrial fibrillation (AF). However the possibility that unsuccessful shocks during IC may influence the AFF has not been before studied. Thirty eight patients with AF, suggested for DC cardioversion at the Royal Victoria Hospital in Belfast, were included in our study. Two catheters were positioned in the right atrial appendage (RAA) and the coronary sinus (CS), to deliver a biphasic shock waveform, synchronized with the R wave of the electrocardiogram (ECG) signal. A voltage step-up protocol (50-300 V) was used for patient cardioversion. The ECG was analyzed for a mean of 52.8plusmn10.1 seconds (corresponding to segments before and after nonsuccessful shocks). Atrial fibrillatory activity was extracted by means of bandpass filtering and ventricular activity (QRST) cancellation. QRST complexes were cancelled using a recursive least squared (RLS) adaptive filter. FFT was applied to the residual atrial fibrillatory signal. AFF was estimated from the dominant frequency within the 3-12 Hz band of the power spectrum. R-R intervals during the segments were also analyzed. A total of 26 patients were successfully cardioverted, employing 167 shocks (141 nonsuccessful). AFF, computed with 10 s of signal, showed significant reduction (mean 0.3052 plusmn 1.1055 Hz, P=0.028) comparing segments immediately before and after shocks, and AFF significantly increases (mean 0.2582 plusmn 0.609 Hz, P=0.007) between segments immediately after shocks and those 35 s after. AFF showed distinct behavior according to the energy level of the shocks. In conclusion, intracardiac electric shocks could cause transitory changes in the AFF of patients with atrial fibrillation.
Starting Page	2591
Ending Page	2594
File Size	1058904
Page Count	4
File Format	PDF
ISBN	9781424407873
ISSN	1557170X
DOI	10.1109/IEMBS.2007.4352859
Language	English
Publisher	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Publisher Date	2007-08-22
Publisher Place	France
Access Restriction	Subscribed
Rights Holder	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Subject Keyword	Electric shock Atrial fibrillation Cardiology Electrocardiography Frequency estimation Hospitals Catheters Frequency synchronization Voltage Protocols
Content Type	Text
Resource Type	Article
Subject	Signal Processing Biomedical Engineering Health Informatics Computer Vision and Pattern Recognition

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