Non-invasive assessment of the effect of beta blockers and calcium channel blockers on the AV node during permanent atrial fibrillation.
OBJECTIVE
We aimed at assessing changes in AV nodal properties during administration of the beta blockers metoprolol and carvedilol, and the calcium channel blockers diltiazem and verapamil from electrocardiographic data.


METHODS
Parameters accounting for the functional refractory periods of the slow and fast pathways (aRPs and aRPf) were estimated using atrial fibrillatory rate (AFR) and ventricular response assessed from 15-min ECG segments recorded at baseline and on drug treatment from sixty patients with permanent AF.


RESULTS
The results showed that AFR and HR were significantly reduced for all drugs, and that aRPs and aRPf were significantly prolonged in both pathways. The prolongation in aRP was significantly larger for the calcium channel blockers than for the beta blockers.


CONCLUSIONS
The changes observed in the AV node parameters are in line with the results of previous electrophysiological studies performed in patients during sinus rhythm, therefore supporting the clinical value of the method.
Department of Biomedical Engineering and Center for Integrative Electrocardiology at Lund University (CIEL), Lund University, Lund, Sweden. Electronic address: frida.sandberg@bme.lth.se.
Frida
F
Sandberg
Department of Electronics, Information and Bioengineering, Politecnico di Milano, Italy.
Valentina D A
VD
Corino
Department of Electronics, Information and Bioengineering, Politecnico di Milano, Italy.
Luca T
LT
Mainardi
Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, 3004, Norway.
Sara R
SR
Ulimoen
Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, 3004, Norway.
Steve
S
Enger
Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, 3004, Norway.
Arnljot
A
Tveit
Center for Integrative Electrocardiology at Lund University (CIEL) and Arrhythmia Clinic, Skåne University Hospital, Lund, Sweden.
Pyotr G
PG
Platonov
Department of Biomedical Engineering and Center for Integrative Electrocardiology at Lund University (CIEL), Lund University, Lund, Sweden.
Leif
L
Sörnmo
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D001283:Atrioventricular Node / Q000187:drug effects / Q000503:physiopathology*; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D002908:Chronic Disease; D018592:Cross-Over Studies; D004562:Electrocardiography / Q000187:drug effects* / Q000379:methods; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers
Atrial fibrillation; Atrioventricular node; Beta blocker; Calcium channel blocker; Functional refractory period; Rate control