Impact of low-level electromagnetic fields on the inducibility of atrial fibrillation in the electrophysiology laboratory

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults. Research suggests that autonomic nervous (ANS) system dysfunction contributes to AF pathophysiology. Animal studies have shown that low-level electromagnetic fields (LL-EMF) are potentially capable of AF suppress...

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Main Authors: Daniel Sohinki, MD, MSc, FACC, FHRS, Joshua Thomas, BS, Benjamin Scherlag, PhD, FHRS, Stavros Stavrakis, MD, PhD, FACC, FHRS, Ali Yousif, MD, Sunny Po, MD, PhD, FHRS, Tarun Dasari, MD, MPH, FACC
Format: Article
Language:English
Published: Elsevier 2021-06-01
Series:Heart Rhythm O2
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666501821000830
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spelling doaj-4a83d432a5be458db9341e852b3d6a332021-09-03T04:47:40ZengElsevierHeart Rhythm O22666-50182021-06-0123239246Impact of low-level electromagnetic fields on the inducibility of atrial fibrillation in the electrophysiology laboratoryDaniel Sohinki, MD, MSc, FACC, FHRS0Joshua Thomas, BS1Benjamin Scherlag, PhD, FHRS2Stavros Stavrakis, MD, PhD, FACC, FHRS3Ali Yousif, MD4Sunny Po, MD, PhD, FHRS5Tarun Dasari, MD, MPH, FACC6Department of Cardiology, Medical College of Georgia at Augusta University, Augusta, Georgia; Address reprint requests and correspondence: Dr Daniel Sohinki, Medical College of Georgia at Augusta University, 1120 15th St, Augusta, GA 30912.Department of Cardiology, Medical College of Georgia at Augusta University, Augusta, GeorgiaDepartment of Cardiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OklahomaDepartment of Cardiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OklahomaDepartment of Cardiology, Baylor Scott and White Health, Prosper, TexasDepartment of Cardiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OklahomaDepartment of Cardiology, University of Oklahoma Health Sciences Center, Oklahoma City, OklahomaBackground: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults. Research suggests that autonomic nervous (ANS) system dysfunction contributes to AF pathophysiology. Animal studies have shown that low-level electromagnetic fields (LL-EMF) are potentially capable of AF suppression. This study evaluated the safety and efficacy of LL-EMF in suppressing AF in humans. Objective: To investigate the impact of LL-EMF on AF inducibility in humans. Methods: Patients presenting for ablation of paroxysmal AF were randomized to a sham protocol or LL-EMF (3.2 × 10-8 G at 0.89 Hz) applied via a Helmholtz coil around the head. AF was induced via atrial pacing, and was cardioverted if duration was greater than 15 minutes. The protocol was then run for 60 minutes, followed by reinduction of AF. The primary endpoint was the duration of pacing-induced AF after protocol completion compared between groups. Results: Eighteen patients completed the study protocol (n = 10 sham, n = 8 LL-EMF). Pacing-induced AF duration in the LL-EMF group was 11.0 ± 3.43 minutes shorter than control after protocol completion (CI 3.72–18.28 minutes, P = .03). A smaller proportion of LL-EMF patients experienced spontaneous firing initiating an AF episode (0/7 vs 5/6, P = .0047). A significantly greater proportion of patients in the control group required direct current cardioversion after 1 hour (0.78 vs 0.13, P = .02). Conclusion: In patients with paroxysmal AF, LL-EMF stimulation results in shorter episodes of pacing-induced AF and a reduced likelihood of spontaneous firing initiating an episode of AF.http://www.sciencedirect.com/science/article/pii/S2666501821000830Atrial fibrillationAutonomic modulationCatheter ablationElectromagnetic fieldsTranslational research
collection DOAJ
language English
format Article
sources DOAJ
author Daniel Sohinki, MD, MSc, FACC, FHRS
Joshua Thomas, BS
Benjamin Scherlag, PhD, FHRS
Stavros Stavrakis, MD, PhD, FACC, FHRS
Ali Yousif, MD
Sunny Po, MD, PhD, FHRS
Tarun Dasari, MD, MPH, FACC
spellingShingle Daniel Sohinki, MD, MSc, FACC, FHRS
Joshua Thomas, BS
Benjamin Scherlag, PhD, FHRS
Stavros Stavrakis, MD, PhD, FACC, FHRS
Ali Yousif, MD
Sunny Po, MD, PhD, FHRS
Tarun Dasari, MD, MPH, FACC
Impact of low-level electromagnetic fields on the inducibility of atrial fibrillation in the electrophysiology laboratory
Heart Rhythm O2
Atrial fibrillation
Autonomic modulation
Catheter ablation
Electromagnetic fields
Translational research
author_facet Daniel Sohinki, MD, MSc, FACC, FHRS
Joshua Thomas, BS
Benjamin Scherlag, PhD, FHRS
Stavros Stavrakis, MD, PhD, FACC, FHRS
Ali Yousif, MD
Sunny Po, MD, PhD, FHRS
Tarun Dasari, MD, MPH, FACC
author_sort Daniel Sohinki, MD, MSc, FACC, FHRS
title Impact of low-level electromagnetic fields on the inducibility of atrial fibrillation in the electrophysiology laboratory
title_short Impact of low-level electromagnetic fields on the inducibility of atrial fibrillation in the electrophysiology laboratory
title_full Impact of low-level electromagnetic fields on the inducibility of atrial fibrillation in the electrophysiology laboratory
title_fullStr Impact of low-level electromagnetic fields on the inducibility of atrial fibrillation in the electrophysiology laboratory
title_full_unstemmed Impact of low-level electromagnetic fields on the inducibility of atrial fibrillation in the electrophysiology laboratory
title_sort impact of low-level electromagnetic fields on the inducibility of atrial fibrillation in the electrophysiology laboratory
publisher Elsevier
series Heart Rhythm O2
issn 2666-5018
publishDate 2021-06-01
description Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults. Research suggests that autonomic nervous (ANS) system dysfunction contributes to AF pathophysiology. Animal studies have shown that low-level electromagnetic fields (LL-EMF) are potentially capable of AF suppression. This study evaluated the safety and efficacy of LL-EMF in suppressing AF in humans. Objective: To investigate the impact of LL-EMF on AF inducibility in humans. Methods: Patients presenting for ablation of paroxysmal AF were randomized to a sham protocol or LL-EMF (3.2 × 10-8 G at 0.89 Hz) applied via a Helmholtz coil around the head. AF was induced via atrial pacing, and was cardioverted if duration was greater than 15 minutes. The protocol was then run for 60 minutes, followed by reinduction of AF. The primary endpoint was the duration of pacing-induced AF after protocol completion compared between groups. Results: Eighteen patients completed the study protocol (n = 10 sham, n = 8 LL-EMF). Pacing-induced AF duration in the LL-EMF group was 11.0 ± 3.43 minutes shorter than control after protocol completion (CI 3.72–18.28 minutes, P = .03). A smaller proportion of LL-EMF patients experienced spontaneous firing initiating an AF episode (0/7 vs 5/6, P = .0047). A significantly greater proportion of patients in the control group required direct current cardioversion after 1 hour (0.78 vs 0.13, P = .02). Conclusion: In patients with paroxysmal AF, LL-EMF stimulation results in shorter episodes of pacing-induced AF and a reduced likelihood of spontaneous firing initiating an episode of AF.
topic Atrial fibrillation
Autonomic modulation
Catheter ablation
Electromagnetic fields
Translational research
url http://www.sciencedirect.com/science/article/pii/S2666501821000830
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