Holm M, Pehrson S, Ingemansson M, Sörnmo L, Johansson R, Sandhall L, Sunemark M, Smideberg B, Olsson C, Olsson S B
Department of Cardiology, University Hospital, Lund, Sweden.
Cardiovasc Res. 1998 Apr;38(1):69-81. doi: 10.1016/s0008-6363(97)00289-7.
Atrial fibrillation (AF) in man has previously been shown to include a wide variety of atrial activity. Assessment of the characteristics of this arrhythmia with a commonly applicable tool may therefore be important in the choice and evaluation of different therapeutic strategies. As the AF cycle length has been shown to correlate locally with atrial refractoriness and globally with the degree of atrial organization, with, in general, shorter cycle length during apparently random AF compared to more organized AF, we have developed a new method for non-invasive assessment of the AF cycle length using the surface and the esophagus (ESO) ECG.
From the frequency spectrum of the residual ECG, created by suppression of the QRST complexes, the dominant atrial cycle length (DACL) was derived. By comparison with multiple intracardiac simultaneously acquired right and left AF cycle lengths in patients with paroxysmal AF, we found that the DACL in lead V1, ranging from 130 to 185 ms, well represented a spatial average of the right AF cycle lengths, whereas the DACL in the ESO ECG, ranging from 140 to 185 ms, reflected both the right and the left AF cycle length, where the influence from each structure depended on the atrial anatomy of the individual, as determined by MRI. In patients with chronic AF, the method was capable of following changes in the AF cycle length due to administration of D,L-sotalol and 5 min of ECG recording was sufficient for the DACL to be reproducible.
We conclude that this new non-invasive method, named 'Frequency Analysis of Fibrillatory ECG' (FAF-ECG), is capable of assessing both the magnitude and the dynamics of the atrial fibrillation cycle length in man.
先前已表明人类心房颤动（AF）包含多种心房活动。因此，使用一种普遍适用的工具评估这种心律失常的特征，对于不同治疗策略的选择和评估可能很重要。由于AF周期长度已显示出与心房不应期局部相关，与心房组织程度全局相关，一般而言，与更有组织的AF相比，明显随机AF期间的周期长度更短，我们开发了一种使用体表和食管（ESO）心电图对AF周期长度进行无创评估的新方法。
通过抑制QRST复合波创建剩余心电图的频谱，得出主要心房周期长度（DACL）。通过与阵发性AF患者同时获取的多个心内右心房和左心房AF周期长度进行比较，我们发现V1导联中的DACL范围为130至185毫秒，很好地代表了右心房AF周期长度的空间平均值，而ESO心电图中的DACL范围为140至185毫秒，反映了右心房和左心房AF周期长度，每个结构的影响取决于个体的心房解剖结构，由MRI确定。在慢性AF患者中，该方法能够跟踪由于给予D，L - 索他洛尔导致的AF周期长度变化，并且5分钟的心电图记录足以使DACL具有可重复性。
我们得出结论，这种名为“颤动心电图频率分析”（FAF - ECG）的新无创方法能够评估人类心房颤动周期长度的大小和动态变化。
