Key result
Dofetilide significantly reduced the dominant frequency of fibrillatory waves from 6.32 Hz at baseline to 4.83 Hz after the final dose (P<0.0001) in patients with persistent atrial fibrillation.
Why the study?
Does dofetilide alter surface ECG f wave characteristics in patients with persistent atrial fibrillation?
Observational (n=31)
Does dofetilide alter surface ECG f wave characteristics in patients with persistent atrial fibrillation?
Dofetilide significantly alters surface ECG f wave characteristics by reducing dominant frequency and increasing organizational index, suggesting standard ECG can be used to assess antiarrhythmic drug effects in atrial fibrillation.
May support noninvasive ECG monitoring of dofetilide effects in persistent AF; hypothesis-generating, needs prospective validation before clinical use.
INTRODUCTION: The electrocardiogram (ECG) fibrillatory (f) wave characteristics in atrial fibrillation (AF) could provide important information regarding the efficacy of antiarrhythmic drug therapy. METHODS AND RESULTS: To measure the effects of dofetilide on the surface ECG f wave characteristics in patients with persistent AF, baseline and post-drug (2 hours after first dose and after multiple doses) ECGs in 31 patients with persistent AF admitted for dofetilide loading were evaluated. A QRST template subtraction algorithm was used to yield an atrial ECG. Fast Fourier transform analysis was performed to evaluate the maximum organizational index (OI), the dominant frequency (DF) in the lead with max OI, the median DF for all leads, and the vector magnitude f wave amplitude. Dofetilide reduced DF in the lead with the max OI (6.32 ± 0.98 Hz at baseline vs. 4.83 ± 0.63 Hz after final dose, P < 0.0001) and median DF (6.46 ± 0.87 Hz vs. 4.92 ± 0.62 Hz, P < 0.0001). Dofetilide also increased the maximum OI from 0.52 ± 0.11 at baseline to 0.59 ± 0.11 after final dose (P = 0.02). Of the 29 patients with long-term follow-up, the 22 (76%) with recurrent AF on dofetilide had a lower baseline DF in the lead with the max OI (6.01 ± 1.08 vs. 6.89 ± 0.46; P = 0.05). The change in DF after dofetilide did not correlate with the change in QTc interval. CONCLUSIONS: The standard ECG can be used to assess atrial rate in AF. This may be useful to assess antiarrhythmic drug effects for treatment of AF.
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Raygor et al. (2015) conducted an observational in Persistent atrial fibrillation (n=31). Dofetilide vs. Baseline was evaluated on Dominant frequency (DF) in the lead with the max organizational index (p=<0.0001). Dofetilide significantly reduced the dominant frequency of fibrillatory waves from 6.32 Hz at baseline to 4.83 Hz after the final dose (P<0.0001) in patients with persistent atrial fibrillation.
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