Surface ECG f wave analysis of dofetilide drug effect in the atrium

Viraj P. Raygor, Jason Ng, Jeffrey Goldberger

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Dofetilide Effect on f Waves in AF 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.

Original languageEnglish (US)
Pages (from-to)644-648
Number of pages5
JournalJournal of Cardiovascular Electrophysiology
Volume26
Issue number6
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Atrial Fibrillation
Electrocardiography
Pharmaceutical Preparations
Anti-Arrhythmia Agents
Fourier Analysis
dofetilide
Drug Therapy
Lead

Keywords

  • atrial fibrillation
  • cardioversion
  • dofetilide
  • dominant frequency
  • QRST subtraction
  • surface ECG

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Surface ECG f wave analysis of dofetilide drug effect in the atrium. / Raygor, Viraj P.; Ng, Jason; Goldberger, Jeffrey.

In: Journal of Cardiovascular Electrophysiology, Vol. 26, No. 6, 01.01.2015, p. 644-648.

Research output: Contribution to journalArticle

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abstract = "Dofetilide Effect on f Waves in AF 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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