Electrocardiographic events preceding onset of atrial fibrillation: insights gained using an implantable loop recorder

Journal of Cardiovascular Electrophysiology
David SchwartzmanRahul Mehra

Abstract

Previous reports demonstrate that individual patients may have distinctive electrocardiographic patterns preceding atrial fibrillation (AF) onset. However, these observations are based on single recordings, and are thus limited by their "snapshot" derivation; it is unclear whether patterns observed on these recordings are consistent over time. We hypothesized that the use of an implantable loop recorder (ILR) would be feasible for serial, long-term characterization of electrocardiographic events preceding AF onset. An ILR was implanted in 29 patients with AF. Patients were instructed to activate the device immediately upon experiencing AF symptoms. Analysis focused on the electrocardiographic segment immediately preceding AF; each segment was classified as one of six patterns: short/long, normal sinus rhythm, absolute sinus bradycardia, relative sinus bradycardia, absolute sinus tachycardia, or relative sinus tachycardia. From a total of 318 device activations, 105 AF onsets were suitable for analysis, acquired from 21 patients over a mean follow-up interval of 7 months. Although AF was frequently triggered by an atrial premature beat that emerged during normal sinus rhythm, most patients demonstrated a variety of onset pattern...Continue Reading

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Citations

Oct 29, 2008·Herzschrittmachertherapie & Elektrophysiologie·Andreas Schuchert
Dec 25, 2008·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·David Schwartzman, Jeffrey L Williams
Apr 30, 2009·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·UNKNOWN Task Force membersUNKNOWN EHRA Scientific Documents Committee
May 11, 2013·Stroke Research and Treatment·Muhib Khan, Daniel J Miller
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Feb 18, 2010·Physica D. Nonlinear Phenomena·Christian W ZemlinArkady M Pertsov
Dec 6, 2007·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Christian W Zemlin, Arkady M Pertsov

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