高分辨率体表心电图心房颤动活动分析：一种新系统的评估与应用

Analysis of atrial fibrillatory activity from high-resolution surface electrocardiograms: Evaluation and application of a new system.

作者信息

Grubitzsch Herko, Modersohn Diethelm, Leuthold Thomas, Konertz Wolfgang

机构信息

Department of Cardiovascular Surgery, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin.

出版信息

Exp Clin Cardiol. 2008 Spring;13(1):29-35.

PMID:18650970

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2435392/

Abstract

BACKGROUND

Algorithms of signal processing allow the estimation of atrial fibrillation (AF) activity from surface electrocardiograms (ECGs).

OBJECTIVE

To evaluate a new commercially available ECG system for AF analysis from surface potentials.

METHODS

Patients (n=52, mean [+/- SD] age of 68+/-9.6 years) with persistent AF (mean duration 44+/-52.2 months), referred for cardiac surgery, underwent high-gain, high-resolution ECG preoperatively. After QRST cancellation, the frequency content of AF was identified by fast Fourier transformation. Epicardial potentials were registered at the right atrial appendage, the right atrium (RA), the left atrium (LA) and the left atrial appendage intraoperatively (nine patients).

RESULTS

Mean (+/- SD) fibrillatory rate (MFR) in lead V(1) (393+/-40.4 fibrillations/min [fpm]) correlated significantly with V(2) (391+/-43.3 fpm, r=0.976; P<0.05) and II (379+/-41.1 fpm, r=0.878; P<0.05), and was stable within an interval of 13.6+/-3.8 min (27 patients). In the right atrial appendage, RA, LA and left atrial appendage, the relative difference in MFR was small (5.6%, 6.6%, 6.8% and 5.7%, respectively, compared with V(1)). The mean peak frequency component at 75% of the maximum power was significantly smaller in the LA than in the RA (13+/-4.2 fpm versus 22+/-7.2 fpm, respectively; P<0.01), and in patients with high (more than 390 fpm) compared with low (390 fpm or fewer) fibrillatory activity (14+/-7.6 fpm versus 22+/-13.3 fpm, respectively; P<0.05). There was a nonsignificant trend to higher fibrillatory activity with longer AF duration. Other characteristics (age, sex, LA size, ejection fraction, type of heart disease and medication) were not associated with the MFR.

CONCLUSIONS

Using the CardioLink system, AF analysis from surface ECG is reliable and equivalent to epicardial measurements. By noninvasive assessment of individual electrical remodelling, this system certainly supports clinical AF research.

摘要

背景

信号处理算法可从体表心电图（ECG）估计房颤（AF）活动。

目的

评估一种新的可商购的用于从体表电位分析房颤的心电图系统。

方法

因心脏手术前来就诊的持续性房颤患者（n = 52，平均[±标准差]年龄68±9.6岁，平均病程44±52.2个月）术前接受高增益、高分辨率心电图检查。在消除QRST波后，通过快速傅里叶变换确定房颤的频率成分。术中在右心耳、右心房（RA）、左心房（LA）和左心耳记录心外膜电位（9例患者）。

结果

V(1)导联的平均（±标准差）颤动率（MFR）（393±40.4次颤动/分钟[fpm]）与V(2)导联（391±43.3 fpm，r = 0.976；P < 0.05）和II导联（379±41.1 fpm，r = 0.878；P < 0.05）显著相关，并且在13.6±3.8分钟的时间段内保持稳定（27例患者）。在右心耳、RA、LA和左心耳，MFR的相对差异较小（与V(1)导联相比分别为5.6%、6.6%、6.8%和5.7%）。LA中最大功率75%时的平均峰值频率成分显著小于RA（分别为13±4.2 fpm和22±7.2 fpm；P < 0.01），并且在颤动活动高（超过390 fpm）的患者中比颤动活动低（390 fpm或更低）的患者小（分别为14±7.6 fpm和22±13.3 fpm；P < 0.05）。房颤持续时间越长，颤动活动有升高的趋势，但无统计学意义。其他特征（年龄、性别、LA大小、射血分数、心脏病类型和用药情况）与MFR无关。