Predicting Successful Transthoracic Cardioversion by Dominant Atrial Fibrillatory Frequency Analysis: The Effects of Bisoprolol

  • J. D. Diaz
  • O. J. Escalona
  • N. C. Castro
  • J. Anderson
  • B. M. Glover
  • G. Manoharan
Conference paper
Part of the IFMBE Proceedings book series (IFMBE, volume 25/7)

Abstract

The most common strategies in the management of atrial fibrillation (AF) involve electrical cardioversion and pharmacological agents. Bisoprolol is a high selective β1 adrenoceptor blocker used for ventricular rate control and to help maintain sinus rhythm. In a retrospective study we com pared ECG frequency domain variables between patients who underwent a successful electrical cardioversion and those that were unsuccessful. As well as this we assessed whether there was a difference in these variables for patients who underwent electrical cardioversion while on bisoprolol. Signal processing was performed on 51 patients undergoing electrical cardioversion: bandpass filtering (0.5-50Hz), QRST cancellation and frequency analysis. An incremental defibrillation energy pro tocol was delivered until cardioversion or up to a maximum level of 200 [J]. The study indicated a significant difference in the dominant AF frequency for long segments (DAFF_L) be tween cardioverted and non-cardioverted subgroups, employ ing an energy less or equal to 100 Joules respectively: (5.5391 ± 1.0396) [Hz] vs. (6.0859 ±0.8071) [Hz] (n=48, p = 0.048), and in patients on bisoprolol: (5.5250 ±1.0302) [Hz] vs. (6.4489 ±0.5828) [Hz] (n=26, p = 0.008). Also, the energy required for successful cardioversion was significantly lower for patients on bisoprolol: (110.00 ± 27.77) [J] vs. (129.41 ±30.92) [J], p=0.046. Also, there was a positive correlation between the DAFF_L and the minimal energy necessary for successful cardioversion (ρ =0.434, p=0.007); a better correlation was obtained for patients on bisoprolol (ρ =0.575, p=0.005). Therefore, analysis of DAFF_L on Lead II can be a useful indicator for predicting defibrillation success in AF patients undergoing transthoracic electric cardioversion, and there is a positive incidence of Bisoprolol upon the values of DAFF_L and electrical cardioversion success at minimal shock energy.

Keywords

Atrial fibrillation cardioversion atrial fibrillatory frequency Bisoprolol effects QRS complex cancellation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • J. D. Diaz
    • 1
  • O. J. Escalona
    • 2
  • N. C. Castro
    • 3
  • J. Anderson
    • 2
  • B. M. Glover
    • 4
  • G. Manoharan
    • 4
  1. 1.Universidad Nacional Experimental Francisco de Miranda, Programa de ElectromedicinaCoroVenezuela
  2. 2.NIBEC, University of UlsterNewtownabbeyUnited Kingdom
  3. 3.Departamento de Electrónica y CircuitosUniversidad Simón BolívarCaracasVenezuela
  4. 4.The Heart Centre, Royal Victoria HospitalBelfastUnited Kingdom

Personalised recommendations