Electrocardiology of atrial fibrillation

Abstract

This article provides an overview and discussion of different available electrocardiographic approaches that my prove useful in the clinical management of patients with atrial fibrillation (AF). At the atrial level, characterization of fibrillation waves during AF using spectral analysis techniques or using P-wave signal averaging during (restored) sinus rhythm has been successfully applied in order to monitor and predict outcome of antiarrhythmic drug therapy and cardioversion. At the ventricular level, heart rate variability (HRV) analysis, RR interval histogram, and Poincare plot analysis have been applied to predict AF onset and recurrence. As with the P-SAECG, the majority of recordings were made, however, during sinus rhythm in paroxysmal or after cardioversion in persistent AF. Developments of new and easy-to-use algorithms for fibrillatory wave classification and ventricular response pattern are examples of possible collaboration between clinicians and bioengineers. Hopefully, in the near future, examination of any AF patient will include direct information on individual electrophysiological, structural, and autonomic characteristics that, at the moment, can only be obtained in a limited number of patients