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Published on: February 26, 2013
Evaluation of Index of Cardio-Electrophysiological Balance in Patients With Atrial Fibrillation on
Abdulmecit Afsin1, Ramazan Asoglu1, Mehmet Ali Kobat2
1Department of Cardiology, Adiyaman Training and Research Hospital, Adiyaman, Turkey.
Insights
Amiodarone and propafenone affect the index of cardio-electrophysiological balance (iCEB) differently in atrial fibrillation (AF) patients. Propafenone showed lower iCEB values, suggesting potential differences in arrhythmia risk management.
Area of Science:
- Cardiology
- Electrophysiology
- Pharmacology
Background:
- The index of cardio-electrophysiological balance (iCEB) is a novel risk marker for malignant ventricular arrhythmias.
- Limited evidence exists on how amiodarone and propafenone impact iCEB in atrial fibrillation (AF) patients undergoing sinus rhythm maintenance.
Purpose of the Study:
- To evaluate the index of cardio-electrophysiological balance (iCEB) in patients with atrial fibrillation (AF) treated with amiodarone or propafenone.
Main Methods:
- 108 AF patients (68 on amiodarone, 40 on propafenone) and 50 controls underwent ECG.
- Calculated QRS duration, QT, Tp-e intervals, iCEB (QT/QRS), and iCEBc (QTc/QRS) for comparison.
Main Results:
- Amiodarone group showed longer QT, Tp-e intervals, and Tp-e/QT ratio compared to propafenone and controls.
- iCEB was similar between amiodarone and control groups, but significantly lower in the propafenone group.
- Heart rate-corrected iCEBc values differed significantly, being highest in the amiodarone group and lowest in the propafenone group.
Conclusions:
- Amiodarone therapy was associated with higher iCEBc parameters, while propafenone was associated with the lowest iCEBc values in AF patients.
- Further research is required to link these electrophysiological changes to ventricular arrhythmia risk in AF patients on antiarrhythmic drugs.
Background:
Index of cardio-electrophysiological balance (iCEB) has been described as a novel risk marker for predicting malignant ventricular arrhythmia. There remains limited evidence on the effects of amiodarone and propafenone used for sinus rhythm maintenance on iCEB in patients with atrial fibrillation (AF). The aim of this study was to evaluate iCEB in patients with AF on antiarrhythmic-drug therapy.
Methods:
A total of 108 patients with AF (68 patients using amiodarone and 40 patients using propafenone) and 50 healthy subjects were included in the study. All groups underwent a standard 12-lead surface electrocardiogram. QRS duration, QT, T wave peak-to-end (Tp-e) intervals, iCEB (QT/QRS) and iCEBc (heart rate-corrected QT (QTc)/QRS) rates were calculated from the electrocardiogram and compared between groups.
Results:
QT, Tp-e intervals and Tp-e/QT ratio were significantly longer in the amiodarone group than the propafenone and control groups (P < 0.001, for all). iCEB was similar in the amiodarone and control groups (4.4 ± 0.6 and 4.2 ± 0.4; P > 0.05), while iCEB values in the propafenone group were significantly lower than the amiodarone group and control groups (3.9 ± 0.5; P < 0.001). There was a significantly difference in iCEBc values among the amiodarone, control and propafenone groups (4.8 ± 0.6, 4.6 ± 0.4 and 4.3 ± 0.6; P < 0.001, respectively).
Conclusions:
In this study, higher iCEBc parameters were observed in patients using amiodarone, while iCEBc values were lowest among patients with AF using propafenone. Further studies are needed to determine whether these electrophysiological changes are associated with ventricular arrhythmias for patients with AF on antiarrhythmic-drug therapy.
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