ECG based assessment of circadian variation in AV-nodal conduction during AF—Influence of rate control drugs

Mattias Karlsson, Mikael Wallman, Pyotr G. Platonov, Sara R. Ulimoen, Frida Sandberg

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskriftPeer review

Sammanfattning

The heart rate during atrial fibrillation (AF) is highly dependent on the conduction properties of the atrioventricular (AV) node. These properties can be affected using β-blockers or calcium channel blockers, mainly chosen empirically. Characterization of individual AV-nodal conduction could assist in personalized treatment selection during AF. Individual AV nodal refractory periods and conduction delays were characterized based on 24-hour ambulatory ECGs from 60 patients with permanent AF. This was done by estimating model parameters from a previously created mathematical network model of the AV node using a problem-specific genetic algorithm. Based on the estimated model parameters, the circadian variation and its drug-dependent difference between treatment with two β-blockers and two calcium channel blockers were quantified on a population level by means of cosinor analysis using a linear mixed-effect approach. The mixed-effects analysis indicated increased refractoriness relative to baseline for all drugs. An additional decrease in circadian variation for parameters representing conduction delay was observed for the β-blockers. This indicates that the two drug types have quantifiable differences in their effects on AV-nodal conduction properties. These differences could be important in treatment outcome, and thus quantifying them could assist in treatment selection.

Originalspråkengelska
Artikelnummer976526
Antal sidor13
TidskriftFrontiers in Physiology
Volym13
DOI
StatusPublished - 2022 okt. 4

Bibliografisk information

Publisher Copyright:
Copyright © 2022 Karlsson, Wallman, Platonov, Ulimoen and Sandberg.

Ämnesklassifikation (UKÄ)

  • Biomedicinsk laboratorievetenskap/teknologi

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