Atrial Fibrillatory Rate Characterization Extracted from Implanted Cardiac Monitor Data

Abstract

The aim of this study is to characterize atrial fibrillatory rate (AFR) extracted from a cohort of continuously monitored atrial fibrillation (AF) patients as function of episode duration and onset time. The f-wave signal used to compute the AFR was extracted from a single lead ECG strip of the AF episodes stored in an Implantable Cardiac Monitor (ICM) in a cohort of 99 patients. The f-wave signals were obtained from 1400 AF episodes using a spatiotemporal QRST cancellation process and the AFR was estimated as the fundamental frequency of a model fitted to the extracted f-waves. We studied the relationship between AFR and episode duration and episode onset time, respectively. AFR (median (interquartile range)) was significantly lower (p-value<0.05) in short episodes (<20 min) (5.15 (0.66) Hz) than in longer episodes (5.30 (0.74) Hz). AFR was significantly higher for episodes with onset time at night (00-06) (5.34 (0.82) Hz) than for episodes with onset during the day (10-20) (5.21 (0.70) Hz). Significant differences were also found between the relative AFR (ratio between the AFR and the average AFR of the patient) and episode duration (Short: 99.2 (9.3) %; Long: 100.0 (8.9) %). Data extracted from ICMs shows that that nighttime AF onset and longer duration AF episodes are more common in patients with higher AFR.