Faculty Collaboration Database

Differentiation of atrial rhythms from the electrocardiogram with coherence spectra. J Electrocardiol 2002 Jan;35(1):59-67

Date

01/12/2002

Pubmed ID

11786948

DOI

10.1054/jelc.2002.29944

Scopus ID

2-s2.0-0036151683 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

Automated electrocardiogram (ECG) interpretation systems fail to reliably discriminate atrial fibrillation from sinus rhythm and other more regular atrial arrhythmias. Previously, magnitude-squared coherence (MSC), a frequency domain measure of the linear phase relation between 2 signals, has been shown to be a reliable discriminator of fibrillatory and nonfibrillatory cardiac rhythms when applied to intracardiac electrograms. This study determines whether MSC, when applied to the surface electrocardiogram, would discriminate between atrial fibrillation and nonfibrillatory atrial rhythms. MSC was analyzed by using 2 surface leads of a 10-second ECG. For 68 ECG recordings (23 sinus rhythm, 22 atrial flutter, and 23 atrial fibrillation), MSC was computed between leads II and V1 and the mean MSC in several frequency bands was examined. The performance of MSC was compared to previously published measures of ventricular irregularity and percent power in discriminating atrial fibrillation from nonfibrillatory rhythms. As hypothesized, atrial fibrillation exhibited low coherence in the 2 to 9 Hz band while nonfibrillatory atrial rhythms exhibited relatively moderate to high levels of coherence in the same frequency band. Mean MSC in the 2 to 9 Hz band was significantly lower for atrial fibrillation (range, 0.04 to 0.48; mean +/- SD: 0.15 +/- 0.11) than for sinus rhythm (range, 0.18 to 0.81; 0.47 +/- 0.17) (P <.0005) and atrial flutter (range, 0.06 to 0.80; 0.44 +/- 0.21) (P <.0005). Mean MSC in the 2 to 9 Hz band showed less overlap between atrial fibrillation and atrial flutter than R-R variability and percent power. However, R-R variability showed less overlap between atrial fibrillation and sinus rhythm than mean MSC and percent power. Thus, MSC and RRV both discriminate atrial fibrillation from more organized atrial rhythms. Conversely, percent power was highly variable for both atrial fibrillation and organized atrial rhythms. Results suggest that MSC applied to surface ECG may be used to quantify rhythm organization.

Author List

Sarraf LS, Roth JA, Ropella KM

Author

James A. Roth MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Atrial Fibrillation
Atrial Flutter
Diagnosis, Differential
Electrocardiography
Female
Heart Conduction System
Humans
Male
Middle Aged
Observer Variation
Sensitivity and Specificity
Sick Sinus Syndrome
Wisconsin