The electrical axis of the heart in patients with atrial fibrillation before and after radiofrequency ablation
DOI:
https://doi.org/10.14739/2310-1210.2018.5.141643Keywords:
atrial fibrillation, catheter ablationAbstract
Aim – to study changes of the electrical axis of the heart in patients with atrial fibrillation before and after radiofrequency ablation with pulmonary veins isolation.
Materials and methods. Data from the study of heart electrical axis (HEA) position in 40 patients (24 men and 16 women) with atrial fibrillation before and during acute postoperative period (3–7 days) after performed radiofrequency ablation with pulmonary vein isolation (RFA PVI) were presented. The values of vector α angle of HEA (αF QRS) and its projections to the frontal (αQRS max F), the sagittal (αQRS max Si) and the horizontal plane (αQRS max H) were determined for the averaged complex in 5 seconds. Patients were divided into 3 groups: the group 1 – normal position of HEA α = 30–70 (n = 10), the group 2 – deviations of HEA to the left α <30 (n = 23) and the group 3 – deviations of HEA to the right – α > 70 (n = 7). The analysis of the changes reliability after the operation was carried out using the Wilcoxon test.
Results. It has been established that the initially bimodal distribution of resultant vector with maxima in the groups 1 and 2 changed to a unimodal asymmetric with a maximum value displacement to the group 1region. The changes in aF QRS max projections on a plane yielded little information. There was a change in the resultant aF QRS in all patients after RFA PVI and in one third (32.5 %) of the patients normalizing of the HEA position took place, and in 5 % – an increase in aF QRS with the transition to the group 3.
Conclusions. A further study of aF QRS changes, a comparison of aF QRS and the atrial vector are required.
References
Sychov, O. S. (2012). Fibrillyaciya predserdij. Sovremennye podkhody k lecheniyu i profilaktike oslozhnenij u pacientov s soputstvuyushchej patologiej serdca [Atrial fibrillation. Modern approaches to the treatment and prevention of complications in patients with concomitant pathology of the heart]. Ukrainskyi medychnyi chasopys, 6(86), 54–57. [in Russian].
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., et al. (2016). 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. European Heart Journal, 37(38), 2893–2962. doi: 10.1093/eurheartj/ehw210.
January, C., Wann, L., Alpert, J., Calkins, H., Cigarroa, J., Cleveland, J., et al. (2014). 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation. Journal of the American College of Cardiology, 64(21), e1–e76.
Prystowsky, E., Padanilam, B., & Fogel, R. (2015). Treatment of Atrial Fibrillation. JAMA, 314(3), 278.
Wecke, L., Poçi, D., Schwieler, J., Johansson, B., Edvardsson, N., Lundahl, G., & Bergfeldt, L. (2013). Vectorcardiography shows cardiac memory and repolarization heterogeneity after ablation of accessory pathways not apparent on ECG. International Journal of Cardiology, 166(1), 152–157. doi: 10.1016/j.ijcard.2011.10.106.
Houghton, A., & Gray, D. (2014). Making sense of the ECG: a hands-on guide. Boca Raton: CRC Press.
Yamashita, S., Date, T., Yamane, T., Matsuo, S., Ito, K., Narui, R., et al. (2011). Noninvasive vectorcardiographic evaluation of pulmonary vein–atrial reconnection after pulmonary vein isolation for atrial fibrillation. Heart Rhythm, 8(9), 1398–1403. doi: 10.1016/j.hrthm.2011.04.023.
Mikio, S., Yasuya, I., Takahisa, S., Naoya, T., Haruo, H., Teruo, I., et al. (2000). Comparison of Vectorcardiographic and 12-lead Electrocardiographic Detections of Abnormalities in Repolarization Properties due to Preexcitation in Patients with Wolff-Parkinson-White Syndrome. Japanese Heart Journal, 41(3), 295–312.
Karayiannides, S., Lundman, P., Friberg, L., & Norhammar, A. (2018). High overall cardiovascular risk and mortality in patients with atrial fibrillation and diabetes: A nationwide report. Diabetes and Vascular Disease Research, 15(1), 31–38. doi: 10.1177/1479164117735013.
Voronenko, O. S., Brynza, M. S., Volkov, D. E., Lopin, D. O., Martynenko, O. V., & Yabluchansky, M. I. (2016). Heart electrical axis α angle values distribution in patients, undergoing permanent pacemaker implantation. Journal of V. N. Karazin` KhNU. Series «Medicine», 31(1), 32–36.
Pérez Riera, A., Uchida, A., Filho, C., Meneghini, A., Ferreira, C., Schapacknik, E., et al. (2007). Significance of Vectorcardiogram in the Cardiological Diagnosis of the 21st Century. Clinical Cardiology, 30(7), 319–323. doi: 10.1002/clc.14.
Chugh, S. N. (2014). Textbook of clinical electrocardiography. New Delhi.
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
