Sohinki Daniel, Thomas Joshua, Scherlag Benjamin, Stavrakis Stavros, Yousif Ali, Po Sunny, Dasari Tarun
Department of Cardiology, Medical College of Georgia at Augusta University, Augusta, Georgia.
Department of Cardiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Heart Rhythm O2. 2021 Apr 30;2(3):239-246. doi: 10.1016/j.hroo.2021.04.004. eCollection 2021 Jun.
BACKGROUND: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults. Research suggests that autonomic nervous (ANS) system dysfunction contributes to AF pathophysiology. Animal studies have shown that low-level electromagnetic fields (LL-EMF) are potentially capable of AF suppression. This study evaluated the safety and efficacy of LL-EMF in suppressing AF in humans. OBJECTIVE: To investigate the impact of LL-EMF on AF inducibility in humans. METHODS: Patients presenting for ablation of paroxysmal AF were randomized to a sham protocol or LL-EMF (3.2 × 10 G at 0.89 Hz) applied via a Helmholtz coil around the head. AF was induced via atrial pacing, and was cardioverted if duration was greater than 15 minutes. The protocol was then run for 60 minutes, followed by reinduction of AF. The primary endpoint was the duration of pacing-induced AF after protocol completion compared between groups. RESULTS: Eighteen patients completed the study protocol (n = 10 sham, n = 8 LL-EMF). Pacing-induced AF duration in the LL-EMF group was 11.0 ± 3.43 minutes shorter than control after protocol completion (CI 3.72-18.28 minutes, = .03). A smaller proportion of LL-EMF patients experienced spontaneous firing initiating an AF episode (0/7 vs 5/6, = .0047). A significantly greater proportion of patients in the control group required direct current cardioversion after 1 hour (0.78 vs 0.13, = .02). CONCLUSION: In patients with paroxysmal AF, LL-EMF stimulation results in shorter episodes of pacing-induced AF and a reduced likelihood of spontaneous firing initiating an episode of AF.
背景:心房颤动(AF)是成年人中最常见的持续性心律失常。研究表明,自主神经系统(ANS)功能障碍促成了AF的病理生理学。动物研究表明,低水平电磁场(LL-EMF)具有潜在的抑制AF的能力。本研究评估了LL-EMF在人类中抑制AF的安全性和有效性。 目的:研究LL-EMF对人类AF诱发性的影响。 方法:因阵发性AF接受消融治疗的患者被随机分为假手术组或通过头部周围的亥姆霍兹线圈施加LL-EMF(0.89赫兹时为3.2×10高斯)。通过心房起搏诱发AF,如果持续时间超过15分钟则进行心脏复律。然后该方案运行60分钟,随后再次诱发AF。主要终点是两组之间方案完成后起搏诱发的AF持续时间。 结果:18名患者完成了研究方案(n = 10假手术组,n = 8 LL-EMF组)。方案完成后,LL-EMF组起搏诱发的AF持续时间比对照组短11.0±3.43分钟(可信区间3.72 - 18.28分钟,P = 0.03)。LL-EMF组中经历自发冲动引发AF发作的患者比例较小(0/7对5/6,P = 0.0047)。1小时后,对照组中需要直流电心脏复律的患者比例显著更高(0.78对0.13,P = 0.02)。 结论:在阵发性AF患者中,LL-EMF刺激导致起搏诱发的AF发作持续时间缩短,且自发冲动引发AF发作的可能性降低。
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