Effects of oral flecainide and amiodarone on atrial fibrillatory frequency in persistent human atrial fibrillation

Atrial Fibrillatory Wave Characteristics on Surface Electrogram:

“…There have been various attempts to examine fibrillatory waves in the hope of gleaning diagnostic or prognostic information about the clinical pattern of fibrillation and drug effects 14–16 . Because electrophysiologic remodeling is associated with characteristic changes in atrial refractory periods, there have been attempts to relate fibrillatory wave characteristics to remodeling 30 .…”

“…Whether these different mechanisms are reflected on the surface ECG is unknown. However, there are data suggesting that fibrillatory wave characteristics reflect aspects of underlying physiology, such as atrial cycle length and refractory period 12,13 and changing clinical conditions, for example, response to antifibrillatory drugs 14–16 . Other studies have shown a correlation between fibrillatory waves and the episode duration of atrial fibrillation 15,17 and associations with spontaneous termination, 15,17 early recurrence, 18,19 successful chemical cardioversion, 20 and minimum defibrillation energy 21 …”

Is Analysis of Fibrillatory Waves Useful for Treatment of Atrial Fibrillation?

“…Analysis of the fibrillatory waves in different animal models of AF has demonstrated that the area with the shortest fibrillatory wave interval was around the PVs. Furthermore, frequency analysis showed a gradient of dominant frequency from the left to right atrium 7–19 . In human studies, analysis of fibrillatory wave recorded from the epicardial electrode plaques or endocardial recordings demonstrated that the dominant frequency was similar between two atria or was slightly higher in the left than the right atrium 20 , 21 .…”

“…Many investigators have examined fibrillatory waves from the surface ECG or intracardiac recordings to elucidate the clinical pattern of AF and the possible effects of antiarrhythmic drugs or cardioversion on AF 8–16 . The results of these studies showed that administration of antifibrillatory drugs could increase the atrial refractory period and decrease fibrillatory wave frequency.…”

Stationarity of surface ECG atrial fibrillatory wave characteristics in the time and frequency domains in clinically stable patients

“…However, f wave characteristics do reflect aspects of underlying physiology such as atrial cycle length and refractory period [6] and change of clinical conditions such as response to anti-fibrillatory drugs [7][8].…”