Frequency Domain ECG Markers for the Treatment of Atrial Fibrillation: Low-Energy Antifibrillation Pacing (LEAP) Cardioversion
Atrial Fibrillation (AF) accounts for 30% to 40% of all abnormal cardiac rhythm related hospitalisations. AF termination can be achieved by electrical shocks delivered to the heart, but this clinical method requires administration of light anaesthesia on the patient. The success of an AF termination (cardioversion) is not simply assessed by the fact of restoring normal heart rhythm, but also for maintaining it. This project is aimed at identifying characteristic frequency domain factors in the recorded electrocardiogram (ECG) which can be used for achieving successful treatment of AF with low-energy antifibrillation pacing (LEAP).
Frequency domain features which are useful for the treatment of AF will be investigated by performing spectral analysis on the body surface ECG signals from AF patients, before being treated. Of particular interest is a feature known as the Atrial Fibrillatory Frequency (AFF), which is a measure on the small background signal in the ECG of an AF patient, when recorded with sufficiently good quality. It has already been found that some characteristics on the AFF, can be useful for implementing successful low-energy antifibrillation pacing (LEAP). This project will provide a better understanding of the mechanism for painless cardioversion of AF. This knowledge will facilitate the clinical decision making about the recommended AF treatment to follow in a particular patient, with possible gains in shorter hospitalisation stay and lower AF treatment costs.
References:
1. Diaz J., Gonzalez C., Escalona O. (2006) “A Support Vector Machine for Predicting Spontaneous Termination of Paroxysmal Atrial Fibrillation Episodes” Computers in Cardiology 2006; 33: 949-952.
2. Bollmann A., Mende M., Neugebauer A., Pfeiffer D. (2002) “Atrial Fibrillatory Frequency Predicts Atrial Defibrillation Threshold And Early Arrhythmia Recurrence In Patients Undergoing Internal Cardioversion Of Persistent Atrial Fibrillation” Journal Of Pacing And Clinical Electrophysiology Vol. 25, No. 8, pp 1179-1184.
3. Diaz J., Escalona O., Anderson J., Glover B., Adgey A. (2006) “Frequency Analysis of Atrial Fibrillation Predicts Success for Low Energy Intracardiac Cardioversion” Proceedings of the World Congress on Medical Physics and Biomedical Engineering, Seoul, 2006, Vol. 14, pp. 910-913, ISBN: 3-540-36839-6.
4. Diaz J, Castro N., Escalona O., Anderson JMcC, Glover B.M., Adgey J.A. (2007) “The effect of internal DC shocks on the atrial fibrillation frequency. Proceedings of the 29th Annual International Conference of the IEEE EMBS, Lyon, France, Aug 23-26, pp. 2591-2594.
5. Díaz J.D., Díaz M.A., Castro N.C., Glover B, Manoharan G, Escalona O.J. (2007) “Use of support vector machines in predicting success of intracardiac cardioversion by electric shocks in patients with atrial fibrillation”, CLAIB 2007: 4th Latin American Congress on Biomedical Engineering, IFMBE Proceedings, vol. 18, pp. 1168-1172.
6. Luther S, et al. (2011). “Low-energy control of electrical turbulence in the heart”, Nature, 14July, Vol. 475: 235-239.
Personnel Involved
First Supervisor: Escalona, OJ Prof
Second Supervisor: Owens, FJ Dr
Collaborator: Dr David McEneaney
Collaboration: Craigavon Area Hospital
Synopsis:
The Atrial Fibrillatory Frequency (AFF) in the ECG of an AF patient will be investigated and characterised in a readily available AF clinical database. This characterisation is aimed to provide markers which are useful for implementing successful low-energy antifibrillation pacing (LEAP), which in turn has the potential to enable protocols and techniques for painless cardioversion of AF.