Noninvasive characterization of atrioventricular conduction in patients with atrial fibrillation.
The atrioventricular (AV) node plays a fundamental role in patients with atrial fibrillation (AF), acting as a filter to the numerous irregular atrial impulses which bombard the node. A phenomenological approach to better understand AV nodal electrophysiology is to analyze the ventricular response with respect to irregularity. In different cohorts of AF patients, such analysis has been performed with the aim to evaluate the association between ventricular response characteristics and long-term clinical outcome and to determine whether irregularity is affected by rate-control drugs. Another approach to studying AV nodal characteristics is to employ a mathematical model which accounts for the refractory periods of the two AV nodal pathways. With atrial fibrillatory rate and RR intervals as input, the model has been considered for analyzing data during (i) rest and head-up tilt test, (ii) tecadenoson and esmolol, and (iii) rate-control drugs. The present paper provides an overview of our recent work on the characterization and assessment of AV nodal conduction using these two approaches.
Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy. Electronic address: valentina.corino@polimi.it.
Valentina D A
VD
Corino
Department of Biomedical Engineering and Center for Integrative Electrocardiology at Lund University (CIEL), Lund University, Lund, Sweden.
Frida
F
Sandberg
Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy.
Luca T
LT
Mainardi
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
D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology*; D001283:Atrioventricular Node / Q000503:physiopathology*; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D004562:Electrocardiography / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008955:Models, Cardiovascular; D018667:Tilt-Table Test / Q000379:methods
Atrioventricular node; Calcium channel blockers; Entropy; Head-up tilt; Irregularity; beta Blockers