Comparison of Distributions of Ventricular Periods During Paroxysmal Atrial Fibrillation and Sinus Rhythm

Katerina Hnatkova,A John Camm,Clif A Alferness,Francis D Murgatroyd,Marek Malik

doi:10.1111/j.1542-474x.1998.tb00404.x

Katerina Hnatkova, A John Camm + Show 3 more

https://doi.org/10.1111/j.1542-474x.1998.tb00404.x

Copy DOI

Export

Save

Cite

Abstract
Full-Text
Similar Papers

Abstract

Listen

Background: The mean ventricular rate is known to be, on average, higher during episodes of paroxysmal atrial fibrillation (AF) than during the sinus rhythm. The data on other statistical parameters of ventricular periods are less known, especially in the respect of atrial premature beats, which are frequent in paroxysmal AF patients while in sinus rhythm.Methods: This study investigated distinction between paroxysmal AF and sinus rhythm based on statistical parameters of 60‐second segments of RR interval series from paroxysmal AF and sinus rhythm episodes. The data of the study were taken from 54 long‐term Holter recordings of 31 paroxysmal AF patients. For each segment, the mean, standard deviation, skewness, and kurtosis of RR intervals were computed. The values obtained from segments of paroxysmal AF and sinus rhythm were used in attempts to distinguish both rhythms. The distinction was evaluated using: (1) statistical comparison of each parameter in each tape; and (2) receiver operator characteristics (ROCs) (dependency of specificity on sensitivity) computed in each tape for each individual parameter as well as for multivariate combinations of all four parameters.Results: The comparison found the mean RR to be the most powerful discriminator of all statistical parameters used in the distinction of paroxysmal AF and sinus rhythm. The standard deviation of RR intervals differentiated significantly the segments of sinus rhythm and paroxysmal AF in pool data. However, when applied to individual Holter recordings, the distinction between paroxysmal AF and sinus rhythm based on standard deviation of RR intervals (assessed with ROC) was the worst among all investigated parameters.Conclusions: The study suggests that an automatic distinction between paroxysmal AF and sinus rhythm episodes is highly problematic, mainly because of the frequent atrial premature beats that pollute sinus rhythm episodes in patients with paroxysmal AF.

Full Text