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Evolution of Changes in the Ventricular Rhythm During Paroxysmal Atrial Fibrillation
Author(s) -
GALLAGHER MARK M.,
HNATKOVA KATERINA,
MURGATROYD FRANCIS D.,
WAKTARE JOHAN E. P.,
GUO XIAHOUA,
CAMM A. JOHN,
MALIK MAREK
Publication year - 1998
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1998.tb01199.x
Subject(s) - medicine , cardiology , atrial fibrillation , paroxysmal atrial fibrillation , rhythm , heart rhythm
Changes in the RR interval within episodes of paroxysmal atrial fibrillation (PAF) have not been fully characterized. A database of 177 24‐hour Holter recordings were created from patients with PAF in the CRAFT studies. PAF episodes of ≥ 1 minute duration containing ≤ 20% noise and preceded by ≥ 1 minute of sinus rhythm with ≤ 20% noise were selected. Sections of each AF episode containing 10 and 25 RR intervals were identified at the onset, middle, and termination of each episode. Descriptive characteristics (mean, SD, and RMSSD of RR intervals) were calculated within each section, and compared using a nonparametric, paired Wilcoxon test. In 25 patients (17 men, 60.6 ± 12.2 years old), 231 episodes from 44 recordings met the selection criteria. The mean RR interval increased slightly between the onset and mid‐portion of AF episodes (565.9 ± 128.3 vs 580.3 ± 144.7 ms, P < 0.001). The RR interval at the termination of AF was significantly greater than that at the start (627.1 ± 156.1 vs 565.9 ms, P < 10–11) or mid‐portion (627.1 ± 156.1 vs 580.3 ± 144.7 ms, P < 10–13). SD of the RR interval increased significantly between onset and mid‐portion (111.1 ± 60.2 vs 118.2 ± 66.7 ms, P < 0.001) and more substantially between mid‐portion and termination (118.2 ± 66.7 vs 201.8 ± 93.7 ms, P < 10–21). During paroxysms of AF, the mean RR interval and the variability of RR intervals increases. Termination of a paroxysm is preceded by a marked increase in RR interval variability.