Markers for silent atrial fibrillation in esophageal long-term electrocardiography

J Electrocardiol. 2016 Jul-Aug;49(4):496-503. doi: 10.1016/j.jelectrocard.2016.03.006. Epub 2016 Mar 7.

Abstract

Purpose: Paroxysmal atrial fibrillation (PAF) often remains undiagnosed. Long-term surface ECG is used for screening, but has limitations. Esophageal ECG (eECG) allows recording high quality atrial signals, which were used to identify markers for PAF.

Methods: In 50 patients (25 patients with PAF; 25 controls) an eECG and surface ECG was recorded simultaneously. Partially A-V blocked atrial runs (PBARs) were quantified, atrial signal duration in eECG was measured.

Results: eECG revealed 1.8‰ of atrial premature beats in patients with known PAF to be PBARs with a median duration of 853ms (interquartile range (IQR) 813-1836ms) and a median atrial cycle length of 366ms (IQR 282-432ms). Even during a short recording duration of 2.1h (IQR 1.2-17.2h), PBARs occurred in 20% of PAF patients but not in controls (p=0.05). Left atrial signal duration was predictive for PAF (72% sensitivity, 80% specificity).

Conclusions: eECG reveals partially blocked atrial runs and prolonged left atrial signal duration - two novel surrogate markers for PAF.

Keywords: atrial fibrillation; esophageal ECG; long-term ECG; surrogate markers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Algorithms
  • Asymptomatic Diseases*
  • Atrial Fibrillation / diagnosis*
  • Biomarkers
  • Diagnosis, Computer-Assisted / methods*
  • Electrocardiography / methods*
  • Esophagus
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Biomarkers