Non-invasive assessment of the effect of beta blockers and calcium channel blockers on the AV node during permanent atrial fibrillation.

Frida Sandberg, Valentina D A Corino, Luca T Mainardi, Sara R Ulimoen, Steve Enger, Arnljot Tveit, Pyotr G Platonov, Leif Sörnmo

Journal: Journal of electrocardiology 2016;48(5):861-6

PMID: 26275982

Full Text on Elsevier Science View on PubMed

Abstract

AIM

We aimed at assessing changes in AV nodal properties during administration of the beta blockers metoprolol and carvedilol, and the calcium channel blockers diltiazem and verapamil from electrocardiographic data.

METHODS

Parameters accounting for the functional refractory periods of the slow and fast pathways (aRPs and aRPf) were estimated using atrial fibrillatory rate (AFR) and ventricular response assessed from 15-min ECG segments recorded at baseline and on drug treatment from sixty patients with permanent AF.

RESULTS

The results showed that AFR and HR were significantly reduced for all drugs, and that aRPs and aRPf were significantly prolonged in both pathways. The prolongation in aRP was significantly larger for the calcium channel blockers than for the beta blockers.

CONCLUSIONS

The changes observed in the AV node parameters are in line with the results of previous electrophysiological studies performed in patients during sinus rhythm, therefore supporting the clinical value of the method.

Address: Department of Biomedical Engineering and Center for Integrative Electrocardiology at Lund University (CIEL), Lund University, Lund, Sweden. Electronic address: [email protected].; Department of Electronics, Information and Bioengineering, Politecnico di Milano, Italy.; Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Drammen, 3004, Norway.; Center for Integrative Electrocardiology at Lund University (CIEL) and Arrhythmia Clinic, Skåne University Hospital, Lund, Sweden.; Department of Biomedical Engineering and Center for Integrative Electrocardiology at Lund University (CIEL), Lund University, Lund, Sweden.

DOI: 10.1016/j.jelectrocard.2015.07.019

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MeSH Terms: Adrenergic beta-Antagonists, Aged, Anti-Arrhythmia Agents, Atrial Fibrillation, Atrioventricular Node, Calcium Channel Blockers, Chronic Disease, Cross-Over Studies, Electrocardiography, Female, Heart Conduction System, Heart Rate, Humans, Male, Prospective Studies, Single-Blind Method, Treatment Outcome