Novel non-invasive P wave analysis for the prediction of paroxysmal atrial fibrillation recurrences in patients without structural heart disease: A prospective pilot study

Vassilios Vassilikos, George Dakos, Yiannis S. Chatzizisis, Ioanna Chouvarda, Charalambos Karvounis, Charles Maynard, Nicos Maglaveras, Stylianos Paraskevaidis, George Stavropoulos, Charalambos I. Styliadis, Sotirios Mochlas, Ioannis Styliadis

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)165-172
Number of pages8
JournalInternational Journal of Cardiology
Volume153
Issue number2
DOIs
StatePublished - Dec 1 2011

Keywords

  • P wave
  • Paroxysmal atrial fibrillation
  • Wavelet analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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