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Sakellaropoulou A, Giannopoulos G, Tachmatzidis D, Letsas KP, Antoniadis A, Asvestas D, Filos D, Mililis P, Efremidis M, Chouvarda I, Vassilikos VP. Association of beat-to-beat P-wave analysis index to the extent of left atrial low-voltage areas in patients with paroxysmal atrial fibrillation. Hellenic J Cardiol 2024:S1109-9666(24)00115-5. [PMID: 38777086 DOI: 10.1016/j.hjc.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 04/16/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Left atrial (LA) fibrosis has been shown to be associated with atrial fibrillation (AF) recurrence. Beat-to-beat (B2B) index is a non-invasive classifier, based on B2B P-wave morphological and wavelet analysis, shown to be associated with AF incidence and recurrence. In this study, we tested the hypothesis that the B2B index is associated with the extent of LA low-voltage areas (LVAs) on electroanatomical mapping. METHODS Patients with paroxysmal AF scheduled for pulmonary vein isolation, without evident structural remodeling, were included. Pre-ablation electroanatomical voltage maps were used to calculate the surface of LVAs (<0.5 mV). B2B index was compared between patients with small versus large LVAs. RESULTS 35 patients were included (87% male, median age 62). The median surface area of LVAs was 7.7 (4.4-15.8) cm2 corresponding to 5.6 (3.3-12.1) % of LA endocardial surface. B2B index was 0.57 (0.52-0.59) in patients with small LVAs (below the median) compared to 0.65 (0.56-0.77) in those with large LVAs (above the median) (p = 0.009). In the receiver operator characteristic curve analysis for predicting large LVAs, the c-statistic was 0.75 (p = 0.006) for B2B index and 0.81 for the multivariable model including B2B index (multivariable p = 0.04) and P-wave duration. CONCLUSION In patients with paroxysmal AF without overt atrial myopathy, B2B P-wave analysis appears to be a useful non-invasive correlate of low-voltage areas-and thus fibrosis-in the LA. This finding establishes a pathophysiological basis for B2B index and its potential usefulness in the selection process of patients who are likely to benefit most from further invasive treatment.
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Affiliation(s)
- Antigoni Sakellaropoulou
- 2nd Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece.
| | - Georgios Giannopoulos
- 3rd Department of Cardiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Tachmatzidis
- 3rd Department of Cardiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos P Letsas
- 2nd Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece
| | - Antonios Antoniadis
- 3rd Department of Cardiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Asvestas
- 2nd Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece
| | - Dimitrios Filos
- Laboratory of Computing, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis Mililis
- 2nd Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece
| | - Michael Efremidis
- 2nd Department of Cardiology, Laboratory of Cardiac Electrophysiology, Evangelismos General Hospital of Athens, Athens, Greece
| | - Ioanna Chouvarda
- Laboratory of Computing, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilios P Vassilikos
- 3rd Department of Cardiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Fleet H, Pilcher D, Bellomo R, Coulson TG. Predicting atrial fibrillation after cardiac surgery: a scoping review of associated factors and systematic review of existing prediction models. Perfusion 2023; 38:92-108. [PMID: 34405746 DOI: 10.1177/02676591211037025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Postoperative atrial fibrillation (POAF) is common after cardiac surgery and associated with increased hospital length of stay, patient morbidity and mortality. We aimed to identify factors associated with POAF and evaluate the accuracy of available POAF prediction models. METHODS We screened articles from Ovid MEDLINE® and PubMed Central® (PMC) and included studies that evaluated risk factors associated with POAF or studies that designed or validated POAF prediction models. We only included studies in cardiac surgical patients with sample size n ⩾ 50 and a POAF outcome group ⩾20. We summarised factors that were associated with POAF and assessed prediction model performance by reviewing reported calibration and discriminative ability. RESULTS We reviewed 232 studies. Of these, 142 fulfilled the inclusion criteria. Age was frequently found to be associated with POAF, while most other variables showed contradictory findings, or were assessed in few studies. Overall, 15 studies specifically developed and/or validated 12 prediction models. Of these, all showed poor discrimination or absent calibration in predicting POAF in externally validated cohorts. CONCLUSIONS Except for age, reporting of factors associated with POAF is inconsistent and often contradictory. Prediction models have low discrimination, missing calibration statistics, are at risk of bias and show limited clinical applicability. This suggests the need for studies that prospectively collect AF relevant data in large cohorts and then proceed to validate findings in external data sets.
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Affiliation(s)
- Hugh Fleet
- Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
| | - David Pilcher
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
| | - Rinaldo Bellomo
- Centre for Integrated Critical Care, The University of Melbourne, Parkville, VIC, Australia
| | - Tim G Coulson
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, Australia
- Centre for Integrated Critical Care, The University of Melbourne, Parkville, VIC, Australia
- Department of Anaesthesia, Austin Hospital, Melbourne, VIC, Australia
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Tachmatzidis D, Tsarouchas A, Mouselimis D, Filos D, Antoniadis AP, Lysitsas DN, Mezilis N, Sakellaropoulou A, Giannopoulos G, Bakogiannis C, Triantafyllou K, Fragakis N, Letsas KP, Asvestas D, Efremidis M, Lazaridis C, Chouvarda I, Vassilikos VP. P-Wave Beat-to-Beat Analysis to Predict Atrial Fibrillation Recurrence after Catheter Ablation. Diagnostics (Basel) 2022; 12:diagnostics12040830. [PMID: 35453877 PMCID: PMC9028701 DOI: 10.3390/diagnostics12040830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 11/23/2022] Open
Abstract
The identification of patients prone to atrial fibrillation (AF) relapse after catheter ablation is essential for better patient selection and risk stratification. The current prospective cohort study aims to validate a novel P-wave index based on beat-to-beat (B2B) P-wave morphological and wavelet analysis designed to detect patients with low burden AF as a predictor of AF recurrence within a year after successful catheter ablation. From a total of 138 consecutive patients scheduled for AF ablation, 12-lead ECG and 10 min vectorcardiogram (VCG) recordings were obtained. Univariate analysis revealed that patients with higher B2B P-wave index had a two-fold risk for AF recurrence (HR: 2.35, 95% CI: 1.24–4.44, p: 0.010), along with prolonged P-wave, interatrial block, early AF recurrence, female gender, heart failure history, previous stroke, and CHA2DS2-VASc score. Multivariate analysis of assessable predictors before ablation revealed that B2B P-wave index, along with heart failure history and a history of previous stroke or transient ischemic attack, are independent predicting factors of atrial fibrillation recurrence. Further studies are needed to assess the predictive value of the B2B index with greater accuracy and evaluate a possible relationship with atrial substrate analysis.
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Affiliation(s)
- Dimitrios Tachmatzidis
- 3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (A.T.); (D.M.); (A.P.A.); (G.G.); (C.B.); (K.T.); (N.F.); (C.L.); (V.P.V.)
- Correspondence:
| | - Anastasios Tsarouchas
- 3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (A.T.); (D.M.); (A.P.A.); (G.G.); (C.B.); (K.T.); (N.F.); (C.L.); (V.P.V.)
| | - Dimitrios Mouselimis
- 3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (A.T.); (D.M.); (A.P.A.); (G.G.); (C.B.); (K.T.); (N.F.); (C.L.); (V.P.V.)
| | - Dimitrios Filos
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (D.F.); (I.C.)
| | - Antonios P. Antoniadis
- 3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (A.T.); (D.M.); (A.P.A.); (G.G.); (C.B.); (K.T.); (N.F.); (C.L.); (V.P.V.)
| | | | - Nikolaos Mezilis
- St. Luke’s Hospital Thessaloniki, 552 36 Thessaloniki, Greece; (D.N.L.); (N.M.)
| | - Antigoni Sakellaropoulou
- Electrophysiology Laboratory, 2nd Department of Cardiology, Evangelismos General Hospital of Athens, 106 76 Athens, Greece; (A.S.); (K.P.L.); (D.A.); (M.E.)
| | - Georgios Giannopoulos
- 3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (A.T.); (D.M.); (A.P.A.); (G.G.); (C.B.); (K.T.); (N.F.); (C.L.); (V.P.V.)
| | - Constantinos Bakogiannis
- 3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (A.T.); (D.M.); (A.P.A.); (G.G.); (C.B.); (K.T.); (N.F.); (C.L.); (V.P.V.)
| | - Konstantinos Triantafyllou
- 3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (A.T.); (D.M.); (A.P.A.); (G.G.); (C.B.); (K.T.); (N.F.); (C.L.); (V.P.V.)
| | - Nikolaos Fragakis
- 3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (A.T.); (D.M.); (A.P.A.); (G.G.); (C.B.); (K.T.); (N.F.); (C.L.); (V.P.V.)
| | - Konstantinos P. Letsas
- Electrophysiology Laboratory, 2nd Department of Cardiology, Evangelismos General Hospital of Athens, 106 76 Athens, Greece; (A.S.); (K.P.L.); (D.A.); (M.E.)
| | - Dimitrios Asvestas
- Electrophysiology Laboratory, 2nd Department of Cardiology, Evangelismos General Hospital of Athens, 106 76 Athens, Greece; (A.S.); (K.P.L.); (D.A.); (M.E.)
| | - Michael Efremidis
- Electrophysiology Laboratory, 2nd Department of Cardiology, Evangelismos General Hospital of Athens, 106 76 Athens, Greece; (A.S.); (K.P.L.); (D.A.); (M.E.)
| | - Charalampos Lazaridis
- 3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (A.T.); (D.M.); (A.P.A.); (G.G.); (C.B.); (K.T.); (N.F.); (C.L.); (V.P.V.)
| | - Ioanna Chouvarda
- Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (D.F.); (I.C.)
| | - Vassilios P. Vassilikos
- 3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece; (A.T.); (D.M.); (A.P.A.); (G.G.); (C.B.); (K.T.); (N.F.); (C.L.); (V.P.V.)
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Patients with atrial fibrillation and mid-range ejection fraction differ in anticoagulation pattern, thrombotic and mortality risk independently of CHA2DS2-VASC score. Heart Vessels 2020; 35:1243-1249. [DOI: 10.1007/s00380-020-01603-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 03/27/2020] [Indexed: 12/28/2022]
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Dakos G, Chatzizisis YS, Konstantinou D, Chouvarda I, Filos D, Paraskevaidis S, Mantziari L, Maglaveras N, Karvounis H, Styliadis I, Vassilikos V. Wavelet-based analysis of P waves identifies patients with lone atrial fibrillation: A cross-sectional pilot study. Int J Cardiol 2014; 174:389-92. [PMID: 24767760 DOI: 10.1016/j.ijcard.2014.03.195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 03/31/2014] [Indexed: 11/17/2022]
Affiliation(s)
- George Dakos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece.
| | - Yiannis S Chatzizisis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece; Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Dimitrios Konstantinou
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Ioanna Chouvarda
- Laboratory of Medical Informatics, Aristotle University Medical School, Thessaloniki, Greece
| | - Dimitrios Filos
- Laboratory of Medical Informatics, Aristotle University Medical School, Thessaloniki, Greece
| | - Stylianos Paraskevaidis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Lilian Mantziari
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece; Department of Cardiology, Electrophysiology Unit, Royal Brompton Hospital, London, UK
| | - Nicos Maglaveras
- Laboratory of Medical Informatics, Aristotle University Medical School, Thessaloniki, Greece
| | - Haralambos Karvounis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Ioannis Styliadis
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece
| | - Vassilios Vassilikos
- First Department of Cardiology, AHEPA University Hospital, Aristotle University Medical School, Thessaloniki, Greece; Third Department of Cardiology, Hippokrateion University Hospital, Aristotle University Medical School, Thessaloniki, Greece
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Banerjee A, Taillandier S, Olesen JB, Lane DA, Lallemand B, Lip GY, Fauchier L. Ejection fraction and outcomes in patients with atrial fibrillation and heart failure: the Loire Valley Atrial Fibrillation Project. Eur J Heart Fail 2014; 14:295-301. [PMID: 22294759 DOI: 10.1093/eurjhf/hfs005] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Amitava Banerjee
- University of Birmingham Centre for Cardiovascular Sciences; City Hospital; Birmingham B18 7QH UK
| | - Sophie Taillandier
- Service de Cardiologie, Pôle Coeur Thorax Vasculaire, Centre Hospitalier, Universitaire Trousseau et Faculté de Médecine; Université François Rabelais; Tours France
| | - Jonas Bjerring Olesen
- University of Birmingham Centre for Cardiovascular Sciences; City Hospital; Birmingham B18 7QH UK
- Department of Cardiology; Copenhagen University Hospital Gentofte; Hellerup 2900 Denmark
| | - Deirdre A. Lane
- University of Birmingham Centre for Cardiovascular Sciences; City Hospital; Birmingham B18 7QH UK
| | - Benedicte Lallemand
- Service de Cardiologie, Pôle Coeur Thorax Vasculaire, Centre Hospitalier, Universitaire Trousseau et Faculté de Médecine; Université François Rabelais; Tours France
| | - Gregory Y.H. Lip
- University of Birmingham Centre for Cardiovascular Sciences; City Hospital; Birmingham B18 7QH UK
| | - Laurent Fauchier
- Service de Cardiologie, Pôle Coeur Thorax Vasculaire, Centre Hospitalier, Universitaire Trousseau et Faculté de Médecine; Université François Rabelais; Tours France
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Martínez A, Alcaraz R, Rieta JJ. Morphological variability of the P-wave for premature envision of paroxysmal atrial fibrillation events. Physiol Meas 2013; 35:1-14. [PMID: 24345763 DOI: 10.1088/0967-3334/35/1/1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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QRS analysis using wavelet transformation for the prediction of response to cardiac resynchronization therapy: a prospective pilot study. J Electrocardiol 2013; 47:59-65. [PMID: 24034302 DOI: 10.1016/j.jelectrocard.2013.08.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Wider QRS and left bundle branch block morphology are related to response to cardiac resynchronization therapy (CRT). A novel time-frequency analysis of the QRS complex may provide additional information in predicting response to CRT. METHODS Signal-averaged electrocardiograms were prospectively recorded, before CRT, in orthogonal leads and QRS decomposition in three frequency bands was performed using the Morlet wavelet transformation. RESULTS Thirty eight patients (age 65±10years, 31 males) were studied. CRT responders (n=28) had wider baseline QRS compared to non-responders and lower QRS energies in all frequency bands. The combination of QRS duration and mean energy in the high frequency band had the best predicting ability (AUC 0.833, 95%CI 0.705-0.962, p=0.002) followed by the maximum energy in the high frequency band (AUC 0.811, 95%CI 0.663-0.960, p=0.004). CONCLUSIONS Wavelet transformation of the QRS complex is useful in predicting response to CRT.
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Girasis C, Vassilikos V, Efthimiadis GK, Papadopoulou SL, Dakos G, Dalamaga EG, Chouvarda I, Giannakoulas G, Kamperidis V, Paraskevaidis S, Maglaveras N, Karvounis HI, Parcharidis GE, Styliadis IH. Patients with hypertrophic cardiomyopathy at risk for paroxysmal atrial fibrillation: advanced echocardiographic evaluation of the left atrium combined with non-invasive P-wave analysis. Eur Heart J Cardiovasc Imaging 2012; 14:425-34. [DOI: 10.1093/ehjci/jes172] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vassilikos V, Dakos G, Chatzizisis YS, Chouvarda I, Karvounis C, Maynard C, Maglaveras N, Paraskevaidis S, Stavropoulos G, Styliadis CI, Mochlas S, Styliadis I. Novel non-invasive P wave analysis for the prediction of paroxysmal atrial fibrillation recurrences in patients without structural heart disease. Int J Cardiol 2011; 153:165-72. [DOI: 10.1016/j.ijcard.2010.08.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Revised: 07/01/2010] [Accepted: 08/08/2010] [Indexed: 11/15/2022]
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Diery A, Rowlands D, Cutmore TRH, James D. Automated ECG diagnostic P-wave analysis using wavelets. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2011; 101:33-43. [PMID: 20537757 DOI: 10.1016/j.cmpb.2010.04.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 03/17/2010] [Accepted: 04/29/2010] [Indexed: 05/29/2023]
Abstract
P-wave characteristics in the human ECG are an important source of information in the diagnosis of atrial conduction pathology. However, diagnosis by visual inspection is a difficult task since the P-wave is relatively small and noise masking is often present. This paper introduces novel wavelet characteristics derived from the continuous wavelet transform (CWT) which are shown to be potentially effective discriminators in an automated diagnostic process. Characteristics of the 12-lead ECG P-wave were derived using CWT and statistical methods. A normal control group and an abnormal (atrial conduction pathology) group were compared. The wavelet characteristics captured frequency, magnitude and variance components of the P-wave. The best individual characteristics (i.e. ones that significantly discriminated the groups) were entered into a linear discriminant analysis (LDA) for four different models: two-lead ECG, three-lead ECG, a derived three-lead ECG and a factor analysis solution consisting of wavelet characteristic loadings on the factors. A comparison was also made between wavelet characteristics derived form individual P-waves verses wavelet characteristics derived from a signal-averaged P-wave for each participant. These wavelet models were also compared to standard cardiological measures of duration, terminal force and duration divided by the PR segment. Results for the individual P-wave approach generally outperformed the standard cardiological measures and the signal-averaged P-wave approach. The best wavelet model on the basis of both classification performance and simplicity was the two-lead model that uses leads II and V1. It was concluded that the wavelet approach of automating classification is worth pursuing with larger samples to validate and extend the present study.
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Affiliation(s)
- A Diery
- Centre for Wireless Monitoring Applications, Griffith University, Brisbane, 4111, Queensland, Australia.
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Sovilj S, Van Oosterom A, Rajsman G, Magjarevic R. ECG-based prediction of atrial fibrillation development following coronary artery bypass grafting. Physiol Meas 2010; 31:663-77. [DOI: 10.1088/0967-3334/31/5/005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Censi F, Calcagnini G, Ricci C, Ricci RP, Santini M, Grammatico A, Bartolini P. P-Wave Morphology Assessment by a Gaussian Functions-Based Model in Atrial Fibrillation Patients. IEEE Trans Biomed Eng 2007; 54:663-72. [PMID: 17405373 DOI: 10.1109/tbme.2006.890134] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Aim of this study was to present a P-wave model, based on a linear combination of Gaussian functions, to quantify morphological aspects of P-wave in patients prone to atrial fibrillation (AF). Five-minute ECG recordings were performed in 25 patients with permanent dual chamber pacemakers. Patients were divided into high-risk and low-risk groups, including patients with and without AF episodes in the last 6 mo preceding the study, respectively. ECG signals were acquired using a 32-lead mapping system for high-resolution biopotential measurement (ActiveTwo, Biosemi, The Netherlands, sample frequency 2 kHz, 24-bit resolution). Up to 8 Gaussian models have been computed for each averaged P-wave extracted from every lead. The P-wave morphology was evaluated by extracting seven parameters. Classical time-domain parameters, based on P-wave duration estimation, have been also estimated. We found that the P-wave morphology can be effectively modeled by a linear combination of Gaussian functions. In addition, the combination of time-domain and morphological parameters extracted from the Gaussian function-based model of the P-wave improves the identification of patients having different risks of developing AF.
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Affiliation(s)
- Federica Censi
- Department of Technologies and Health, Istituto Superiore di Sanità, Rome 00161, Italy.
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