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P wave analysis with wavelets identifies hypertensive patients at risk of recurrence of atrial fibrillation: A case-control study and 1year follow-up.

Abstract：

AIMS:Hypertension is a major risk factor for atrial fibrillation (AF); however, reliable non-invasive tools to assess AF risk in hypertensive patients are lacking. We sought to evaluate the efficacy of P wave wavelet analysis in predicting AF risk recurrence in a hypertensive cohort. METHODS:We studied 37 hypertensive patients who presented with an AF episode for the first time and 37 age- and sex-matched hypertensive controls without AF. P wave duration and energy variables were measured for each subject [i.e. mean and max P wave energy along horizontal (x), coronal (y) and sagittal (z) axes in low, intermediate and high frequency bands]. AF-free survival was assessed over a follow-up of 12.1±0.4months. RESULTS:P wave duration (Pdurz) and mean P wave energy in the intermediate frequency band across sagittal axis (mean2z) were independently associated with baseline AF status (p=0.008 and p=0.001, respectively). Based on optimal cut-off points, four groups were formed: Pdurz<83.2ms/mean2z<6.2μV(2) (n=23), Pdurz<83.2ms/mean2z≥6.2μV(2) (n=10), Pdurz≥83.2ms/mean2z<6.2μV(2) (n=22) and Pdurz≥83.2ms/mean2z≥6.2μV(2) (n=19). AF-free survival decreased (Log Rank p<0.0001) from low risk (Pdurz<83.2ms/mean2z<6.2μV(2)) to high-risk group (Pdurz≥83.2ms/mean2z≥6.2μV(2)). Patients presenting with longer and higher energy P waves were at 18 times higher AF risk compared to those with neither (OR: 17.6, 95% CI: 3.7-84.3) even after adjustment for age, sex, hypertension duration, left atrial size, beta-blocker, ACEi/ARBs and statin therapy. CONCLUSIONS:P wave temporal and energy characteristics extracted using wavelet analysis can potentially serve as screening tool to identify hypertensive patients at risk of AF recurrence.

journal_name

J Electrocardiol

journal_title

Journal of electrocardiology

authors

Dakos G,Konstantinou D,Chatzizisis YS,Chouvarda I,Filos D,Paraskevaidis S,Mantziari L,Maglaveras N,Karvounis H,Vassilikos V

doi

10.1016/j.jelectrocard.2015.07.012

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

845-52

issue

eissn

0022-0736

issn

1532-8430

pii

S0022-0736(15)00212-5

journal_volume

pub_type

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P wave analysis with wavelets identifies hypertensive patients at risk of recurrence of atrial fibrillation: A case-control study and 1year follow-up.