P wave analysis with wavelets identifies hypertensive patients at risk of recurrence of atrial fibrillation: A case-control study and 1year follow-up.
Τίτλος | P wave analysis with wavelets identifies hypertensive patients at risk of recurrence of atrial fibrillation: A case-control study and 1year follow-up. |
Publication Type | Journal Article |
Year of Publication | 2015 |
Authors | Dakos, G., Konstantinou D., Chatzizisis Y. S., Chouvarda I., Filos D., Paraskevaidis S., Mantziari L., Maglaveras N., Karvounis H., & Vassilikos V. |
Journal | J Electrocardiol |
Volume | 48 |
Issue | 5 |
Pagination | 845-52 |
Date Published | 2015 Sep-Oct |
ISSN | 1532-8430 |
Abstract | AIMS: Hypertension is a major risk factor for atrial fibrillation (AF); however, reliable non-invasive tools to assess AF risk in hypertensive patients are lacking. We sought to evaluate the efficacy of P wave wavelet analysis in predicting AF risk recurrence in a hypertensive cohort.METHODS: We studied 37 hypertensive patients who presented with an AF episode for the first time and 37 age- and sex-matched hypertensive controls without AF. P wave duration and energy variables were measured for each subject [i.e. mean and max P wave energy along horizontal (x), coronal (y) and sagittal (z) axes in low, intermediate and high frequency bands]. AF-free survival was assessed over a follow-up of 12.1±0.4months.RESULTS: P wave duration (Pdurz) and mean P wave energy in the intermediate frequency band across sagittal axis (mean2z) were independently associated with baseline AF status (p=0.008 and p=0.001, respectively). Based on optimal cut-off points, four groups were formed: Pdurz<83.2ms/mean2z<6.2μV(2) (n=23), Pdurz<83.2ms/mean2z≥6.2μV(2) (n=10), Pdurz≥83.2ms/mean2z<6.2μV(2) (n=22) and Pdurz≥83.2ms/mean2z≥6.2μV(2) (n=19). AF-free survival decreased (Log Rank p<0.0001) from low risk (Pdurz<83.2ms/mean2z<6.2μV(2)) to high-risk group (Pdurz≥83.2ms/mean2z≥6.2μV(2)). Patients presenting with longer and higher energy P waves were at 18 times higher AF risk compared to those with neither (OR: 17.6, 95% CI: 3.7-84.3) even after adjustment for age, sex, hypertension duration, left atrial size, beta-blocker, ACEi/ARBs and statin therapy.CONCLUSIONS: P wave temporal and energy characteristics extracted using wavelet analysis can potentially serve as screening tool to identify hypertensive patients at risk of AF recurrence. |
DOI | 10.1016/j.jelectrocard.2015.07.012 |
Alternate Journal | J Electrocardiol |
PubMed ID | 26216370 |