Study Atrial Fibrillation By Dynamic Electrocardiograms

Objective To investigate ventricular heart rate (HR) changes of persistent atrial fibrillation (AF) and circadian variation of the onset, maintenance and termination of paroxysmal atrial fibrillation (PAF), possible factors of eliciting PAF, dynamic changes of P wave dispersion. Methods Monitored by 3-lead and 12 -lead dynamic Electrocardiograms (DCG). Analyzed the changes of heart rate with parameters of ventricular rate and hourly frequency gram. Observed circadian variation of onset and termination incidence and time lasting changes. Studied HR variation of sinus rhythm before 5 minutes attacking, relationship between premature atrial contraction, coupling interval and PAF episodes. Calculated P wave dispersion before PAF attacking and 1 hour before. Results (1) In persistent AF group most fast, most slowly and average HR, compared within two groups, P<0.001. It showed the regulative rhythm of fast in daytime and slow in the night. (2) PAF episodes began to increase from 3Am, became peak from 4Am to 6Am.Circadian variation of onset and termination kept same. Persistent peak was between 11Am to 4Pm. (3) Before PAF attacking, there were 78 episodes, which HR was lower than 60bpm (32.09%), companied by 68 episodes, which LF/HF<1.5(87.18%). There were 52 episodes which HR was faster than 90bpm (21.3%), companied by 43 episodes which LF/HF> 2.0 (82.69%) . (4) The coupling interval of premature atrial contractions eliciting PAF (453. 21±57.32ms) compared with coupling interval of less than 500ms, P<0.05, 0.01; (5)P wave dispersions of immediately before and 1 hour before onset were 46.8±9.45ms and 43.20± 7.83ms, P<0.05. Conclusions DCG was very important and valuable, in which evaluated HR control of persistent AF, analyzed circadian variation of the onset, maintenance and termination of PAF, studied the relationship among sinus rhythm of PAF attacking and before attacking, autonomic nervous system, premature atrial contractions and coupling interval. It can provide evidence for clinical treatment, such as prediction the incidence of PAF and conversion et al.12-lead DCG can directly show ambulatory changes of P wave dispersion before PAF onset. It was more correctly than routine 12-lead ECG in diagnos ing.