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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Ibutilide increases the variability and complexity of atrial fibrillation electrograms: Antiarrhythmic insights using signal analyses
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Ibutilide increases the variability and complexity of atrial fibrillation electrograms: Antiarrhythmic insights using signal analyses

机译：伊布利特增加心房颤动电描记图的变异性和复杂性：使用信号分析的抗心律失常见解

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Introduction Intravenous ibutilide is used to convert atrial fibrillation (AF) to sinus rhythm (SR) due to its Class III antiarrhythmic mechanisms. However, the effects of ibutilide on local electrograms (EGMs) during AF have not been elucidated. Methods and Results We used EGM analysis techniques to characterize how ibutilide administration changes the frequency, morphology, and repeatability of AF EGM signals, thereby providing insight into ibutilide's antiarrhythmic mechanism of action. AF recordings were collected from 21 patients with AF, both before and after ibutilide administration. The effects of ibutilide on the following AF EGM parameters were assessed: (1) dominant frequency (DF), (2) variations in EGM amplitude and overall morphology, (3) repetition of EGM patterns, and (4) complexity of the AF frequency spectra. When comparing pre- versus post-ibutilide administration EGMs, DF decreased from 5.45 Hz to 4.02 Hz (P < 0.0001). There was an increase in the variability of both AF EGM amplitudes (P = 0.003) and overall AF EGM morphologies (P = 0.003). AF EGM pattern repetitiveness decreased (P = 0.01), and the AF frequency spectral profile manifested greater complexity (P = 0.02). Conclusions Novel EGM signal analysis techniques reveal that ibutilide administration causes increased complexity in the atrial electrical activation pattern with decreasing rate. These findings may be explained by the progressive destabilization of higher frequency, more homogeneous primary drivers of AF over the course of ibutilide administration, and/or less uniform propagation of atrial activation, until AF maintenance becomes more difficult and either transforms to atrial tachycardia or terminates to SR.
机译：前言静脉依布利特由于其III类抗心律不齐的机制而被用于将房颤（AF）转换为窦性心律（SR）。然而，尚未阐明伊布利特对房颤期间局部电描记图（EGM）的影响。方法和结果我们使用EGM分析技术来表征依布利特给药如何改变AF EGM信号的频率，形态和可重复性，从而提供对依布利特抗心律失常作用机制的了解。在伊布利特给药之前和之后，从21例AF患者中收集了AF记录。评估了依布利特对以下AF EGM参数的影响：（1）主导频率（DF），（2）EGM振幅和整体形态的变化，（3）EGM模式的重复以及（4）AF频率的复杂性光谱。比较伊布利特前后的EGMs时，DF从5.45 Hz下降至4.02 Hz（P <0.0001）。 AF EGM振幅（P = 0.003）和整体AF EGM形态（P = 0.003）的变异性都有所增加。 AF EGM模式的重复性降低（P = 0.01），并且AF频谱轮廓显示出更大的复杂性（P = 0.02）。结论新颖的EGM信号分析技术表明，依布利特的使用会导致心房电激活模式的复杂性随着速率的降低而增加。这些发现可以用较高的频率，在依布利特给药过程中房颤的主要驱动因素逐渐失稳和/或房室激活的传播较不均匀来解释，直到房颤维持变得更加困难并转变为房性心动过速或终止SR。

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