Increase in organization index predicts atrial fibrillation termination with flecainide post-ablation: spectral analysis of intracardiac electrograms
Increase in organization index predicts atrial fibrillation termination with flecainide post-ablation: spectral analysis of intracardiac electrograms
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DOI：
10.1093/europace/eup405
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发表时间：
2010-04-01
期刊：
影响因子：
6.1
通讯作者：
Ng, G. Andre
中科院分区：
文献类型：
--
作者：
Tuan, Jiun;Osman, Faizel;Ng, G. Andre
目的氟卡尼终止人心房颤动（AF）的作用机制尚未完全清楚。我们研究了AF电图的时间和频率域的急性影响，以确定与AF termination.Methods和结果AF导管消融术结束时仍在AF患者静脉氟卡尼。通过快速傅立叶变换获得AF患者冠状窦导管电图的优势频率（DF）和组织指数（OI），在氟卡尼输注前后。还计算了平均AF周期长度（CL）。研究了26例患者（16例阵发性房颤和10例持续性房颤）。7例患者使用氟卡尼后转为窦性心律。所有患者的平均CL从211 +/- 44增加到321 +/- 85 ms（P < 0.001）。平均DF从5.2 +/- 1.03降低到3.6 +/- 1.04 Hz（P < 0.001）。氟卡尼治疗前平均OI为0.33 ± 0.13，治疗后为0.32 ± 0.11（P = 0.90）。将转换为SR的患者与未转换为SR的患者进行比较，氟卡尼治疗后OI分别为0.41 +/- 0.12 vs. 0.29 +/- 0.10（P = 0.013），OI的相对变化分别为29 +/- 33 vs. -3.9 +/- 27%（P = 0.016）。两组CL和DF的变化无显著性差异。结论OI的增加，独立于CL和DF的变化，似乎是氟卡尼终止AF的关键。OI增加有望作为AF终止的敏感预测因子。
Aims The mechanism of the action of flecainide in the termination of human atrial fibrillation (AF) is not fully understood. We studied the acute effects of flecainide on AF electrograms in the time and frequency domain to identify factors associated with AF termination.Methods and results Patients who were still in AF at the end of catheter ablation for AF were given intravenous flecainide. Dominant frequency (DF) and organization index (OI) were obtained by fast Fourier transform of electrograms from the coronary sinus catheter over 10 s in AF, before and after flecainide infusion. Mean AF cycle length (CL) was also calculated. Twenty-six patients were studied (16 paroxysmal AF and 10 persistent AF). Seven converted to sinus rhythm (SR) with flecainide. In all patients, mean CL increased from 211 +/- 44 to 321 +/- 85 ms (P < 0.001). Mean DF decreased from 5.2 +/- 1.03 to 3.6 +/- 1.04 Hz (P < 0.001). Mean OI was 0.33 +/- 0.13 before and 0.32 +/- 0.11 after flecainide (P = 0.90). Comparing patients who converted to SR with those who did not, OI post-flecainide was 0.41 +/- 0.12 vs. 0.29 +/- 0.10 (P = 0.013), and the relative change in OI was 29 +/- 33 vs. -3.9 +/- 27% (P = 0.016), respectively. No significant difference was noted in the change in CL and DF in the two groups.Conclusion Increase in OI, independent of changes to CL and DF, appears critical to AF termination with flecainide. Increase in OI holds promise as a sensitive predictor of AF termination.