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Characteristics of conduction in Bachmann’s bundle during pacing Analyzing features of paced signals and their activation patterns during high resolution mapping at patients with and without a history of atrial fibrillation

Engelbert, P. and Kool, D. and te Nijenhuis, L. and Peters, B. (2017) Characteristics of conduction in Bachmann’s bundle during pacing Analyzing features of paced signals and their activation patterns during high resolution mapping at patients with and without a history of atrial fibrillation.

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Abstract:Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia and its treatment is not always effective. In this research the conduction in Bachmann’s bundle (BB) is investigated during pacing to gain insight into the mechanism of AF. BB is an interatrial conduction pathway and might play an important role in the initiation and perpetuation of AF. Method: Epicardial electrograms (EGM) obtained by high resolution mapping during pacing of 11 patients without a history of AF and 12 patients with a history of AF was analyzed by scripts written in Matlab. The activation times of the atrial signal were determined and plotted in a grid to visualize the conduction in BB. Also, the number of conduction delays, conduction blocks, fractionations, the ratio of fractionations and conduction abnormalities and the mean distance from a fractionation to a conduction abnormality were calculated. These results were displayed in boxplots and analyzed by a Mann-Whitney U test in SPSS to compare the data between patients with and without a history of AF. Furthermore, to investigate the mean distance between fractionations and a conduction abnormality a confidence interval was used. Results and discussion: In the number of conduction delays, blocks and the direction in the grid no significant differences were found between patients with and without a history of AF. The fact that not all patients showed induced AF can explain this outcome. Also, the number of fractionations and the mean distance showed no significant difference, probably due to the other factors that could cause fractionations. The 95% confidence interval showed that the mean distance is between 1,90 and 3,92 mm. The ratio between the number of fractionations and conduction abnormalities showed that these do not change. Conclusion: The direction in BB can be described by the number and location of conduction abnormalities. The location of conduction delays and conduction blocks can describe the location of fractionations. Further research is needed to confirm that the number of conduction abnormalities can describe the number of fractionations. No significant differences in the conduction in BB were found between patients with and without a history of AF.
Item Type:Essay (Bachelor)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine BSc (50033)
Link to this item:http://purl.utwente.nl/essays/72568
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