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- Title
ECG based assessment of circadian variation in AV-nodal conduction during AF—Influence of rate control drugs.
- Authors
Karlsson, Mattias; Wallman, Mikael; Platonov, Pyotr G.; Ulimoen, Sara R.; Sandberg, Frida
- Abstract
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.
- Subjects
CALCIUM antagonists; ATRIOVENTRICULAR node; ATRIAL fibrillation; HEART beat; GENETIC algorithms; PALPITATION; GENETIC correlations
- Publication
Frontiers in Physiology, 2022, Vol 13, p1
- ISSN
1664-042X
- Publication type
Article
- DOI
10.3389/fphys.2022.976526