心房纖維顫動之體表心電圖顫動波頻率分析及應用

Frequency Analysis of Atrial Fibrillation Activity on the Surface Electrocardiogram

高材(Tsair Kao) ； 劉安錫(Ann-Shin Liu) ； 戴慶泰(Ching-Tai Tai) ； 陳適安(Shih-Ann Chen) ； 徐良育(Liang-Yu Shyu)

《Journal of Medical and Biological Engineering》 20卷2期 (2000/06) Pp. 2-7

摘要

心房纖維顫動（atrial fibrillation, AF）是一種心房跳動過速的心律不整。在體表心電圖上的顫動波之頻率分析可以顯示心房纖維顫動時的平均心房跳動率。本研究利用適應性濾波器從V1導程心電圖獲得心房纖維顫動波，分析慢性心房纖維顫動病患於抗心律不整藥物注射前後顫動波之頻率變化情形。以recursive least-squares（RLS）演算法去除V1導程心電圖之QRS-T 波後所得到的顫動波，再經由Fourier 轉換得到主頻率。研究中病患注射的藥物分成兩類，分別是procainamide（第一類病人，6 位）與sotalol（第二類病人，6 位）。在藥物注射過程中主頻率減少的變化分別是35.3±6.6%及21.9±6.2%（P=0.02）。所有病人於藥物注射後，電擊心房去顫都成功地回復竇性節律。第一類病人所使用的能量低於第二類病人者，分別是175±29 與275±50 J （P=0.01）。另有29位慢性心房纖維顫動病人進行電擊心房去顫，有26位病患成功地回復竇性節律。由去顫前所作之體表心電圖頻率分析，發現電擊心房去顫的成功率和主頻有正相關性（Spearman 係數，R=0.414，P=0.035）。體表心電圖之顫動波的頻率分析可作為非侵入式評估心房纖維顫動的工具。

關鍵字

心房纖維顫動 ； 適應性濾波器 ； 頻率分析

並列摘要

It has been demonstrated that spectral analysis of the fibrillatory wave (FW) recorded on the surface electrocardiogram (ECG) accurately reflects the average rate of atrial fibrillation (AF). In this study, an adaptive filtering technique was used for quantifying the frequency spectrum of AF from the surface ECG. The FW in lead V1 was extracted using recursive least-squares algorithm. The signal was then subjected to Fourier transform. The effects of antiarrhythmic drugs (AAD) on the peak frequency (PF) of FW in patients with chronic AF (CAF) were evaluated. Intravenous procainamide was given in 6 patients (group I) and intravenous sotalol in another 6 patients (group II) prior to electrical cardioversion (EC). There was a significant decrease in PF during the course of AAD infusion in both groups (35.3±6.6% vs. 21.9±6.2%, P=0.02). All patients had successful EC of AF to sinus rhythm. The energy delivered was significantly less in group I (175±29 J vs. 275±50 J, P=0.01). Another 29 CAF patients referred for EC, 26 patients had successful EC. There was a positive correlation between the energy delivered for successful EC and the PF of CAF patients (Spearman coefficient, R=0.414, P=0.035). Spectral analysis of the fibrillatory activity on the surface ECG has been proved to be useful for noninvasive assessment of the behavior of the arrhythmia.

並列關鍵字

Atrial fibrillation ； Adaptive filtering ； Frequency analysis Received