Key result
Long-term follow-up of patients with persistent atrial fibrillation revealed a significant shortening of the mean fibrillation cycle length from 160 ms to 151 ms.
Observational (n=38)
No
Absolute Event Rate: 151% vs 160%
p-value: p=0.01
In patients with persistent atrial fibrillation, the fibrillation cycle length shortens over time, indicating progressive electrical remodeling that can be monitored noninvasively via surface ECG.
May support noninvasive ECG monitoring of remodeling in persistent AF; leaves open effects on outcomes or therapy.
BACKGROUND: Little is known about the shortening of atrial refractoriness as a result of electrical remodeling in atrial fibrillation (AF) in clinical cases, especially in terms of long-term follow-up, because of a lack of noninvasive testing methods. METHODS AND RESULTS: The present study population comprised 38 consecutive patients with persistent AF (PAF, >1 month). Before and after the follow-up period of 1-14 months, surface ECGs were recorded for analysis. In each case, the fibrillation wave was purified by subtracting the QRS-T complex template and then power spectral analysis was performed. The mean fibrillation cycle length (FCL) and FCL coefficient of variation (FCL-CV) were determined from peak power frequency in 20 epochs in each recording. The change in FCL (FCL) was calculated by subtracting the baseline FCL from the FCL after the follow-up period. To correct for the difference in the follow-up period, DeltaFCL was divided by the follow-up period in each case. In 38 cases, mean FCL decreased from 160+/-20 ms to 151+/-19 ms (p<0.05), and the FCL-CV also decreased from 15+/-9% to 12+/-5% (p<0.05). The corrected DeltaFCL was -2.4+/-7.6 (ms/month) and there was a significant negative correlation between corrected DeltaFCL and baseline FCL (p<0.01). CONCLUSION: Shortening of the FCL during a relatively long-term follow-up period was observed in patients with PAF.
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Sasaki et al. (2006) conducted an observational in Persistent Atrial Fibrillation (n=38). Long-term follow-up vs. Baseline was evaluated on Fibrillation cycle length (FCL) (p=0.01). Long-term follow-up of patients with persistent atrial fibrillation revealed a significant shortening of the mean fibrillation cycle length from 160 ms to 151 ms.
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