P‐wave indices as predictors of atrial fibrillation

Abstract

Background P‐wave duration (PDURATION) and P‐wave area (PAREA) have been linked to risk of atrial fibrillation (AF), but they do not improve the efficacy of Framingham AF risk score. We suggest the incorporation of both variables in one index, the P‐wave area/P‐wave duration (PAREA/DURATION) index, which may be considered an expression of the average amplitude of the P wave that reflects aspects of P‐wave morphology. Objective To assess the prognostic value of P‐wave area/P‐wave duration index (PAREA/DURATION index) in lead II together with other P‐wave indices (PWIs) in incidence of AF in the Copenhagen Holter Study. Methods The study included 632 men and women, between 55 and 75 years with no apparent heart disease or AF. Baseline standard 12‐lead Electrocardiography (ECGs) were analyzed manually. Results The median follow‐up time was 14.7 (14.5;14.9) years. A total of 68 cases of AF and 233 cases of death were recorded. The restricted cubic spline method showed a U‐shaped association between PAREA/DURATION and rate of AF. The lowest quintile of PAREA/DURATION index in lead II was associated with increased rate of AF, HR 2.80 (1.64–4.79). The addition of the new index to the Framingham model for AF improved the model in this population. The PAREA in lead II in its lowest quintile was also associated with increased rate of AF, HR 2.16 (1.25–3.75), but did not improve the Framingham model. PDURATION and P‐wave terminal force (PTF) were not significantly associated with AF. Conclusion A flat P wave as expressed by a small PAREA/DURATION index in lead II is associated with increased rate of incident AF beyond known AF risk factors.

New Clinical Bayes Syndrome: Definitions, Epidemiology and Clinical Significance

“…В 2020 г. авторы M. Martínez-Sellés et al опубликовали результаты многоцентрового исследования BAYES Registry: согласно полученным данным, полная МПБ у пожилых людей (старше 70 лет) была независимо связана с ФП (ОR 2,94; 95% ДИ 1,7-5,1; р<0,001), инсультом (ОR 3,8; 95% ДИ 1,4-10,7; р=0,010) и ФП/инсультом (ОR 2,6; 95% ДИ 1,5-4,4; р=0,001); а продолжительность зубца P определена в качестве независимого фактора риска ФП (ОR 1,05; 95% ДИ 1,03-1,07; р<0,001), ФП/инсульта (HR 1,04; 95% ДИ 1,02-1,06; р<0,001) и смерти (HR 1,04; 95% ДИ 1,00-1,08; р=0,021) [23]. В ряде других исследований также установлены связи высокой силы между полной МПБ и наджелудочковыми аритмиями, определены факторы риска 4 аномальных параметров Р-волны, ассоциированных с худшим прогнозом в различных клинических группах [7][8][9][10][11][12][13][14][22][23][24][25][26][27]. Основные…”

Signs of left atrial disease and 10-year risk of atrial fibrillation

“…In a multivariable analysis of data from the Framingham Heart Study (PTFV 1 was not significantly associated with AF [29]. Rasmussen et al evaluated different P-wave-indices from the Copenhagen Holter study and incorporated them into a clinical risk score developed from data of the Framingham Heart Study but could not show an improved AF risk discrimination for PTFV 1 [30]. Adding echocardiographic measurements to a clinical AF risk score showed a slight…”

Classification of Atrial Fibrillation and Congestive Heart Failure Using Convolutional Neural Network with Electrocardiogram

“…In an ECG complex, the P wave measures electrical activity in the atrium. A flat P wave is associated with an increased rate of AF due to atrial muscle loss and prolonged conduction time [9]. Meanwhile, CHF is a chronic cardiac disease due to a malfunction of the left ventricle (LV), the main contractile chamber that pumps blood throughout the body.…”