Bpt. Hoekstra et al., NONLINEAR-ANALYSIS OF THE PHARMACOLOGICAL CONVERSION OF SUSTAINED ATRIAL-FIBRILLATION IN CONSCIOUS GOATS BY THE CLASS IC DRUG CIBENZOLINE, Chaos, 7(3), 1997, pp. 430-446
Methods from nonlinear dynamics were applied to test the hypothesis th
at the dynamics of sustained atrial fibrillation (AF) is modified by t
he class Ic drug cibenzoline during pharmacological conversion. The ex
periments were performed in conscious goats in which sustained AF was
induced by continuous maintenance of AF via programmed electrical stim
ulation. Data were collected from electrophysiological experiments in
five goats to terminate sustained AF by continuous infusion of cibenzo
line. Sets of five unipolar epicardial electrograms of one minute dura
tion were recorded from the left and right atrial free wall during sus
tained AF (control), and at three episodes during infusion of cibenzol
ine, when the mean AF interval had been prolonged to 25%, 50% and 85%
with respect to control. Ventricular far-field potentials were removed
from atrial electrograms by a coherent averaging procedure. Using the
Grassberger-Procaccia method, the dynamics of the local atrial electr
ograms was investigated by estimating the (coarse-grained) correlation
dimension and correlation entropy from the correlation integral. The
results were related to a recently proposed classification (types I-II
I) of AF based on the degree of complexity of atrial activation patter
ns. The coarse-grained correlation dimension D-cg and entropy K-cg ind
icated that sustained AF corresponded to type Il. During drug administ
ration the coarse-grained parameters were not significantly different
from control. Scaling regions in the correlation integral were observe
d after infusion of cibenzoline (3 out of 5 goats) suggesting that the
drug introduced low-dimensional features (type I) in the dynamics of
AF (correlation dimension D ranging from 2.8 to 4.4 and correlation en
tropy K from 1.6 to 6.2 nats/s). Sinus rhythm recorded shortly after c
ardioversion was very regular (D<2 and K<3 nats/s). The hypothesis tha
t the electrograms during AF and sinus rhythm were generated by a stat
ic transformation of a linear Gaussian random process was rejected usi
ng a test for time reversibility. The nonlinear analysis revealed that
cibenzoline does not significantly alter the dynamics of sustained AF
during pharmacological conversion other than a slowing down of the at
rial activation and a somewhat increasing global organization of the a
trial activation pattern. The sudden change in the dynamical behavior
at cardioversion suggests a mechanism that is reminiscent of a bifurca
tion. (C) 1997 American Institute of Physics.