Meta-analysis of P wave character as predictor of atrial fibrillation after coronary artery bypass grafting

The Amplitude of Fibrillatory Waves on Leads aVF and V1 Predicting the Recurrence of Persistent Atrial Fibrillation Patients Who Underwent Catheter Ablation

“…There were several studies about the ECG parameters to predict the development of AF. Perez et al analyzed 42,751 ECGs and found that the P‐wave index, the standard deviation of P‐wave duration across all leads, was one of the strongest predictors of AF. Bacquer et al found the combination of longer duration with morphologic changes (notched or deflected) in the P wave was a very important risk indicator for the development of AF over 10 years in apparently healthy subjects aged 55 to 74 years.…”

“…Ozdemir et al found that the maximal P‐wave duration > 134.5ms was a predictor of AF in patients with hypertrophic cardiomyopathy. Zhang et al did a meta‐analysis of ten studies and found prolonged P‐wave duration and signal average P wave increased the risk of AF after coronary artery bypass graft. Xi et al analyzed F wave in 238 patients with AF and found higher F‐wave frequency in permanent than paroxysmal AF, which was consistent with that F wave was modified by both electrophysiologic and structural remodeling.…”

The ECG as a tool to determine atrial fibrillation complexity

“…In atrial fibrillation (AF) however, the ECG is mainly used to confirm the diagnosis, to monitor the effect of antiarrhythmic drugs (AADs) and to adjust rate-control. Some studies show that during sinus rhythm (SR) the P-wave duration can to some extent predict AF after coronary bypass surgery or new-onset AF 1 2. Also, atrial ectopy in the recovery phase after normal exercise testing predicts AF in subjects with LV hypertrophy 3…”

Atrial fibrillation in end stage renal disease patients: influence of hemodialysis on P wave duration and atrial dimension

“…Lack of knowledge about anatomical and functional substrate modifications predisposing uremic patients to arrhythmia makes it difficult to identify subjects at high risk of atrial fibrillation onset. Pwd is a new index for atrial fibrillation risk stratification that reflects the intra-atrial conduction velocity [22] and can be useful to identify patients at high risk of developing arrhythmias in diverse patient groups [15][16][17][18]. The hemodialysis session induces electrolyte and blood volume modifications that can modify atrial electrophysiology towards a condition of acute electrical remodeling favoring atrial fibrillation onset [19,23,24], but the predictive value of Pwd for atrial fibrillation risk in uremic patients has not yet been investigated.…”

“…Among them, P-wave (Pw) analysis by high-frequency ECG [signalaveraged P wave (SAPW)] provides information on the intra-atrial conduction velocity. SAPW showed that a prolongation of Pw duration (Pwd) is associated with a higher incidence of AF and may predict the probability of developing AF or arrhythmia recurrences after cardiac surgery [15,16], acute myocardial infarction [17], or electrical cardioversion [18]. We recently demonstrated in end stage renal disease (ESRD) patients a Pwd increase during the HD session, inversely correlated to potassium shifts [19].…”