The Effect of Beat Interval on Ventricular Repolarisation in Atrial Fibrillation

Atrial fibrillation (AF) is characterised by rapid beat interval changes. The aim of the study was to investigate the effect of such changes on ECG ventricular repolarisation characteristics. In 10 AF recordings beat averaging of lead V4 was used to generate averaged T waves where the preceding beat interval (R-R) was either short (625+/−25 ms) or long (1075+/−25 ms). The amplitudes of T wave (T amp) and T wave end, defined as the TU nadir, (TUn amp), and the intervals for R wave to T wave peak (R-T) and R wave to T wave end (R-TUn) where measured from these average beats. Difference in measured T wave characteristics between short and long beat intervals were quantified. All measurements increased significantly for long preceding beat intervals compared to short: T amp (mean±SD) 0.31±0.17 mV (short) vs 0.35±0.20 mV (long) (p = 0.04); TUn amp 0.00±0.02 mV (short) vs 0.03±0.03 mV (long) (p = 0.009); R-T 251.7±13.5 ms (short) vs 264.2±12 ms (long) (p = 0.002) and R-TUn 376.5±31 ms (short) vs 392±26.5 ms (long) (p=0.027). ECG T wave characteristics are significantly affected by preceding ventricular beat interval in AF.