Novel non-invasive P wave analysis for the prediction of paroxysmal atrial fibrillation recurrences in patients without structural heart disease: a prospective pilot study.
Title | Novel non-invasive P wave analysis for the prediction of paroxysmal atrial fibrillation recurrences in patients without structural heart disease: a prospective pilot study. |
Publication Type | Journal Article |
Year of Publication | 2011 |
Authors | Vassilikos, V., Dakos G., Chatzizisis Y. S., Chouvarda I., Karvounis C., Maynard C., Maglaveras N., Paraskevaidis S., Stavropoulos G., Styliadis C. I., Mochlas S., & Styliadis I. |
Journal | Int J Cardiol |
Volume | 153 |
Issue | 2 |
Pagination | 165-72 |
Date Published | 2011 Dec 1 |
ISSN | 1874-1754 |
Keywords | Adult, Aged, Atrial Fibrillation, Echocardiography, Electrocardiography, Female, Humans, Male, Middle Aged, Pilot Projects, Predictive Value of Tests, Prospective Studies, Recurrence |
Abstract | OBJECTIVES: The pathogenetic mechanisms responsible for the initiation and recurrence of PAF are not fully elucidated and vary among individuals. We evaluated the ability of a novel non-invasive approach based on P wave wavelet analysis to predict symptomatic paroxysmal atrial fibrillation (PAF) recurrences in individuals without structural heart disease.METHODS: We studied 50 patients (24 males, mean age 54.9 ± 9.8 years) presented to our emergency department with a symptomatic episode of PAF. The patients were followed-up for 12.1 ± 0.1 months and classified into two groups according to the number of PAF episodes: Group A (<5 PAF, n = 33), Group B (≥ 5 PAF, n = 17). A third Group of 50 healthy individuals without history of PAF was used as control. Study groups underwent echocardiography and orthogonal ECG-based wavelet analyses of P waves at baseline and follow-up. Maximum and mean P wave energies were calculated in each subject at each orthogonal lead using the Morlet wavelet analysis.RESULTS: Larger P wave energies at X lead and relatively larger left atrium were independently associated with >5 PAF episodes vs. <5 PAF episodes. No difference in P wave duration was detected between Groups A and B (p > 0.1), whereas Group A and B patients had longer P waves at Z lead compared to Group C (86.4 ± 13 vs. 71.5 ± 15 msec, p < 0.001).CONCLUSIONS: P wave wavelet analysis can reliably predict the generation and recurrence of PAF within a year. P wave wavelet analysis could contribute to the early identification of patients at risk for increased number of PAF recurrences. |
DOI | 10.1016/j.ijcard.2010.08.029 |
Alternate Journal | Int. J. Cardiol. |
PubMed ID | 20837368 |