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ECG Features

Date: 2018-02-09
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ECG Features

Atrial fibrillation belongs to supraventricular arrhythmias. Its typical ECG performance is normal atrial wave (P wave) is replaced by f wave with irregular ventricular rhythms. f wave usually shows as a small amplitude of baseline oscillation. Its frequency usually ranges from 300 to 600 bpm, with changeable amplitude, shape and period. In comparison, the frequency of atrial flutter is 250 ~ 350 bpm, with stable shape and period.

In the absence of negative conduction factors, the ventricular rate of a tpical atrial fibrillation is usually from 100 to 160 bpm. In patients with W-PW syndrome, the ventricular rate could exceed 250 bpm due to atrial bypassing.

 

Atrial Fibrillation Classification

When a patient has had two or more episodes, and terminates spontaneously, it is designated as paroxysmal AF; but if it is sustained beyond 7 days, it is termed persistent AF. When the duration is greater than 1 year, and it is difficult to be converted, it is called “long-standing AF”. However, “long-standing AF” is not literally permanent, as it can be successfully converted by surgery or radiofrequency ablation.

In 1987, Professor James L. Cox first applied Cox-Maze Procedure to treat atrial fibrillation. The Maze-I procedure adopted “cut and sew” surgical technique to prevent macro-reentry which has more complications to impede its application. The Maze IV procedure utilizing new energy sources (radiofrequency ablation and cryoablation) combing surgical technique, which is minimal invasive, significantly reduced aortic crossclamp time and complications such as postoperative bleeding and conduction block. As reported, the freedom from AF rate after surgical ablation is up to 90% in 1 year, 85% in three years.

 

Atrial Fibrillation Epidemiology

Atrial fibrillation is the most common and most treated cardiac arrhythmia in clinical practice. About 33% of arrhythmia associated hospitalization is due to atrial fibrillation. When compared with AF-free patients, there is a 5-fold increase in the incidence of stroke, and a 2-fold increase in all cause mortality risk. It is also associated with exacerbation of heart failure. The prevalence of AF in adult population is about 1-2%, and it is increased with age, over 5-15% in octogenarian. The total number of Chinese patients with atrial fibrillation is about 10 million.


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2018 - 02 - 09
ECG FeaturesAtrial fibrillation belongs to supraventricular arrhythmias. Its typical ECG performance is normal atrial wave (P wave) is replaced by f wave with irregular ventricular rhythms. f wave usually shows as a small amplitude of baseline oscillation. Its frequency usually ranges from 300 to 600 bpm, with changeable amplitude, shape and period. In comparison, the frequency of atrial flutter i...
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