Use of global atrial fibrillation organization to optimize the success of burst pace termination

Thomas Everett, Joseph G. Akar, Lai Chow Kok, J. Randall Moorman, David E. Haines

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

OBJECTIVES: The purpose of this study was to determine if burst atrial pacing would have an effect on terminating atrial fibrillation. BACKGROUND: We hypothesized that frequency domain analysis of a filtered wide bipolar atrial electrogram describes the global organization of atrial fibrillation (AF) and should vary over time. Timing burst pacing to periods of high organization of AF should promote regional atrial conduction block and terminate AF. METHODS: Nine dogs were conditioned with rapid atrial pacing for 48 h. Electrogram recordings were made from a wide right atrium (RA) to left atrium (LA) bipole and digitally filtered. A fast-Fourier transform was performed every 0.5 s on a sliding 2-s window, and the organization index (OI) was calculated as a ratio of the area of the first four harmonic peaks to the total power of the spectrum. Organization indexes >0.5 indicated more organized AF activity. Right atrium and LA burst pacing (burst) (cycle length 50 ms, 9.9 ms, 9.9 mA, 1 to 4 s) was performed through decapolar catheters. Burst was either random or synchronized to OI >0.5. RESULTS: Burst termination was attempted 1,814 times (889 OI sync, 925 random) and succeeded in seven of nine dogs. Burst had an overall success rate of 11.1% versus 6.3% for random (p < 0.0003). Biatrial pacing had the highest efficacy for terminating AF, with a success rate of 16.5% for OI sync versus 8.2% for random (p < 0.0001). CONCLUSIONS: Timing the delivery of the burst pace when the OI is >0.5 increases the efficacy of burst pace termination of AF. Biatrial pacing is more effective than either RA or LA pacing alone.

Original languageEnglish (US)
Pages (from-to)1831-1840
Number of pages10
JournalJournal of the American College of Cardiology
Volume40
Issue number10
DOIs
StatePublished - Nov 20 2002

Fingerprint

Heart Atria
Atrial Fibrillation
Dogs
Cardiac Electrophysiologic Techniques
Fourier Analysis
Catheters

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Use of global atrial fibrillation organization to optimize the success of burst pace termination. / Everett, Thomas; Akar, Joseph G.; Kok, Lai Chow; Moorman, J. Randall; Haines, David E.

In: Journal of the American College of Cardiology, Vol. 40, No. 10, 20.11.2002, p. 1831-1840.

Research output: Contribution to journalArticle

Everett, Thomas ; Akar, Joseph G. ; Kok, Lai Chow ; Moorman, J. Randall ; Haines, David E. / Use of global atrial fibrillation organization to optimize the success of burst pace termination. In: Journal of the American College of Cardiology. 2002 ; Vol. 40, No. 10. pp. 1831-1840.
@article{8a2aaf065b1440c8bb689a8723d148eb,
title = "Use of global atrial fibrillation organization to optimize the success of burst pace termination",
abstract = "OBJECTIVES: The purpose of this study was to determine if burst atrial pacing would have an effect on terminating atrial fibrillation. BACKGROUND: We hypothesized that frequency domain analysis of a filtered wide bipolar atrial electrogram describes the global organization of atrial fibrillation (AF) and should vary over time. Timing burst pacing to periods of high organization of AF should promote regional atrial conduction block and terminate AF. METHODS: Nine dogs were conditioned with rapid atrial pacing for 48 h. Electrogram recordings were made from a wide right atrium (RA) to left atrium (LA) bipole and digitally filtered. A fast-Fourier transform was performed every 0.5 s on a sliding 2-s window, and the organization index (OI) was calculated as a ratio of the area of the first four harmonic peaks to the total power of the spectrum. Organization indexes >0.5 indicated more organized AF activity. Right atrium and LA burst pacing (burst) (cycle length 50 ms, 9.9 ms, 9.9 mA, 1 to 4 s) was performed through decapolar catheters. Burst was either random or synchronized to OI >0.5. RESULTS: Burst termination was attempted 1,814 times (889 OI sync, 925 random) and succeeded in seven of nine dogs. Burst had an overall success rate of 11.1{\%} versus 6.3{\%} for random (p < 0.0003). Biatrial pacing had the highest efficacy for terminating AF, with a success rate of 16.5{\%} for OI sync versus 8.2{\%} for random (p < 0.0001). CONCLUSIONS: Timing the delivery of the burst pace when the OI is >0.5 increases the efficacy of burst pace termination of AF. Biatrial pacing is more effective than either RA or LA pacing alone.",
author = "Thomas Everett and Akar, {Joseph G.} and Kok, {Lai Chow} and Moorman, {J. Randall} and Haines, {David E.}",
year = "2002",
month = "11",
day = "20",
doi = "10.1016/S0735-1097(02)02476-2",
language = "English (US)",
volume = "40",
pages = "1831--1840",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "10",

}

TY - JOUR

T1 - Use of global atrial fibrillation organization to optimize the success of burst pace termination

AU - Everett, Thomas

AU - Akar, Joseph G.

AU - Kok, Lai Chow

AU - Moorman, J. Randall

AU - Haines, David E.

PY - 2002/11/20

Y1 - 2002/11/20

N2 - OBJECTIVES: The purpose of this study was to determine if burst atrial pacing would have an effect on terminating atrial fibrillation. BACKGROUND: We hypothesized that frequency domain analysis of a filtered wide bipolar atrial electrogram describes the global organization of atrial fibrillation (AF) and should vary over time. Timing burst pacing to periods of high organization of AF should promote regional atrial conduction block and terminate AF. METHODS: Nine dogs were conditioned with rapid atrial pacing for 48 h. Electrogram recordings were made from a wide right atrium (RA) to left atrium (LA) bipole and digitally filtered. A fast-Fourier transform was performed every 0.5 s on a sliding 2-s window, and the organization index (OI) was calculated as a ratio of the area of the first four harmonic peaks to the total power of the spectrum. Organization indexes >0.5 indicated more organized AF activity. Right atrium and LA burst pacing (burst) (cycle length 50 ms, 9.9 ms, 9.9 mA, 1 to 4 s) was performed through decapolar catheters. Burst was either random or synchronized to OI >0.5. RESULTS: Burst termination was attempted 1,814 times (889 OI sync, 925 random) and succeeded in seven of nine dogs. Burst had an overall success rate of 11.1% versus 6.3% for random (p < 0.0003). Biatrial pacing had the highest efficacy for terminating AF, with a success rate of 16.5% for OI sync versus 8.2% for random (p < 0.0001). CONCLUSIONS: Timing the delivery of the burst pace when the OI is >0.5 increases the efficacy of burst pace termination of AF. Biatrial pacing is more effective than either RA or LA pacing alone.

AB - OBJECTIVES: The purpose of this study was to determine if burst atrial pacing would have an effect on terminating atrial fibrillation. BACKGROUND: We hypothesized that frequency domain analysis of a filtered wide bipolar atrial electrogram describes the global organization of atrial fibrillation (AF) and should vary over time. Timing burst pacing to periods of high organization of AF should promote regional atrial conduction block and terminate AF. METHODS: Nine dogs were conditioned with rapid atrial pacing for 48 h. Electrogram recordings were made from a wide right atrium (RA) to left atrium (LA) bipole and digitally filtered. A fast-Fourier transform was performed every 0.5 s on a sliding 2-s window, and the organization index (OI) was calculated as a ratio of the area of the first four harmonic peaks to the total power of the spectrum. Organization indexes >0.5 indicated more organized AF activity. Right atrium and LA burst pacing (burst) (cycle length 50 ms, 9.9 ms, 9.9 mA, 1 to 4 s) was performed through decapolar catheters. Burst was either random or synchronized to OI >0.5. RESULTS: Burst termination was attempted 1,814 times (889 OI sync, 925 random) and succeeded in seven of nine dogs. Burst had an overall success rate of 11.1% versus 6.3% for random (p < 0.0003). Biatrial pacing had the highest efficacy for terminating AF, with a success rate of 16.5% for OI sync versus 8.2% for random (p < 0.0001). CONCLUSIONS: Timing the delivery of the burst pace when the OI is >0.5 increases the efficacy of burst pace termination of AF. Biatrial pacing is more effective than either RA or LA pacing alone.

UR - http://www.scopus.com/inward/record.url?scp=0037145937&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037145937&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(02)02476-2

DO - 10.1016/S0735-1097(02)02476-2

M3 - Article

C2 - 12446068

AN - SCOPUS:0037145937

VL - 40

SP - 1831

EP - 1840

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 10

ER -