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Beat-to-Beat P-Wave Analysis Outperforms Conventional P-Wave Indices in Identifying Patients with a History of Paroxysmal Atrial Fibrillation during Sinus Rhythm

Early identification of patients at risk for paroxysmal atrial fibrillation (PAF) is essential to attain optimal treatment and a favorable prognosis. We compared the performance of a beat-to-beat (B2B) P-wave analysis with that of standard P-wave indices (SPWIs) in identifying patients prone to PAF....

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Autores principales: Tachmatzidis, Dimitrios, Filos, Dimitrios, Chouvarda, Ioanna, Tsarouchas, Anastasios, Mouselimis, Dimitrios, Bakogiannis, Constantinos, Lazaridis, Charalampos, Triantafyllou, Konstantinos, Antoniadis, Antonios P., Fragakis, Nikolaos, Efthimiadis, Georgios, Maglaveras, Nicos, Tsalikakis, Dimitrios G., Vassilikos, Vassilios P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470012/
https://www.ncbi.nlm.nih.gov/pubmed/34574035
http://dx.doi.org/10.3390/diagnostics11091694
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author Tachmatzidis, Dimitrios
Filos, Dimitrios
Chouvarda, Ioanna
Tsarouchas, Anastasios
Mouselimis, Dimitrios
Bakogiannis, Constantinos
Lazaridis, Charalampos
Triantafyllou, Konstantinos
Antoniadis, Antonios P.
Fragakis, Nikolaos
Efthimiadis, Georgios
Maglaveras, Nicos
Tsalikakis, Dimitrios G.
Vassilikos, Vassilios P.
author_facet Tachmatzidis, Dimitrios
Filos, Dimitrios
Chouvarda, Ioanna
Tsarouchas, Anastasios
Mouselimis, Dimitrios
Bakogiannis, Constantinos
Lazaridis, Charalampos
Triantafyllou, Konstantinos
Antoniadis, Antonios P.
Fragakis, Nikolaos
Efthimiadis, Georgios
Maglaveras, Nicos
Tsalikakis, Dimitrios G.
Vassilikos, Vassilios P.
author_sort Tachmatzidis, Dimitrios
collection PubMed
description Early identification of patients at risk for paroxysmal atrial fibrillation (PAF) is essential to attain optimal treatment and a favorable prognosis. We compared the performance of a beat-to-beat (B2B) P-wave analysis with that of standard P-wave indices (SPWIs) in identifying patients prone to PAF. To this end, 12-lead ECG and 10 min vectorcardiogram (VCG) recordings were obtained from 33 consecutive, antiarrhythmic therapy naïve patients, with a short history of low burden PAF, and from 56 age- and sex-matched individuals with no AF history. For both groups, SPWIs were calculated, while the VCG recordings were analyzed on a B2B basis, and the P-waves were classified to a primary or secondary morphology. Wavelet transform was used to further analyze P-wave signals of main morphology. Univariate analysis revealed that none of the SPWIs performed acceptably in PAF detection, while five B2B features reached an AUC above 0.7. Moreover, multivariate logistic regression analysis was used to develop two classifiers—one based on B2B analysis derived features and one using only SPWIs. The B2B classifier was found to be superior to SPWIs classifier; B2B AUC: 0.849 (0.754–0.917) vs. SPWIs AUC: 0.721 (0.613–0.813), p value: 0.041. Therefore, in the studied population, the proposed B2B P-wave analysis outperforms SPWIs in detecting patients with PAF while in sinus rhythm. This can be used in further clinical trials regarding the prognosis of such patients.
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spelling pubmed-84700122021-09-27 Beat-to-Beat P-Wave Analysis Outperforms Conventional P-Wave Indices in Identifying Patients with a History of Paroxysmal Atrial Fibrillation during Sinus Rhythm Tachmatzidis, Dimitrios Filos, Dimitrios Chouvarda, Ioanna Tsarouchas, Anastasios Mouselimis, Dimitrios Bakogiannis, Constantinos Lazaridis, Charalampos Triantafyllou, Konstantinos Antoniadis, Antonios P. Fragakis, Nikolaos Efthimiadis, Georgios Maglaveras, Nicos Tsalikakis, Dimitrios G. Vassilikos, Vassilios P. Diagnostics (Basel) Article Early identification of patients at risk for paroxysmal atrial fibrillation (PAF) is essential to attain optimal treatment and a favorable prognosis. We compared the performance of a beat-to-beat (B2B) P-wave analysis with that of standard P-wave indices (SPWIs) in identifying patients prone to PAF. To this end, 12-lead ECG and 10 min vectorcardiogram (VCG) recordings were obtained from 33 consecutive, antiarrhythmic therapy naïve patients, with a short history of low burden PAF, and from 56 age- and sex-matched individuals with no AF history. For both groups, SPWIs were calculated, while the VCG recordings were analyzed on a B2B basis, and the P-waves were classified to a primary or secondary morphology. Wavelet transform was used to further analyze P-wave signals of main morphology. Univariate analysis revealed that none of the SPWIs performed acceptably in PAF detection, while five B2B features reached an AUC above 0.7. Moreover, multivariate logistic regression analysis was used to develop two classifiers—one based on B2B analysis derived features and one using only SPWIs. The B2B classifier was found to be superior to SPWIs classifier; B2B AUC: 0.849 (0.754–0.917) vs. SPWIs AUC: 0.721 (0.613–0.813), p value: 0.041. Therefore, in the studied population, the proposed B2B P-wave analysis outperforms SPWIs in detecting patients with PAF while in sinus rhythm. This can be used in further clinical trials regarding the prognosis of such patients. MDPI 2021-09-17 /pmc/articles/PMC8470012/ /pubmed/34574035 http://dx.doi.org/10.3390/diagnostics11091694 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tachmatzidis, Dimitrios
Filos, Dimitrios
Chouvarda, Ioanna
Tsarouchas, Anastasios
Mouselimis, Dimitrios
Bakogiannis, Constantinos
Lazaridis, Charalampos
Triantafyllou, Konstantinos
Antoniadis, Antonios P.
Fragakis, Nikolaos
Efthimiadis, Georgios
Maglaveras, Nicos
Tsalikakis, Dimitrios G.
Vassilikos, Vassilios P.
Beat-to-Beat P-Wave Analysis Outperforms Conventional P-Wave Indices in Identifying Patients with a History of Paroxysmal Atrial Fibrillation during Sinus Rhythm
title Beat-to-Beat P-Wave Analysis Outperforms Conventional P-Wave Indices in Identifying Patients with a History of Paroxysmal Atrial Fibrillation during Sinus Rhythm
title_full Beat-to-Beat P-Wave Analysis Outperforms Conventional P-Wave Indices in Identifying Patients with a History of Paroxysmal Atrial Fibrillation during Sinus Rhythm
title_fullStr Beat-to-Beat P-Wave Analysis Outperforms Conventional P-Wave Indices in Identifying Patients with a History of Paroxysmal Atrial Fibrillation during Sinus Rhythm
title_full_unstemmed Beat-to-Beat P-Wave Analysis Outperforms Conventional P-Wave Indices in Identifying Patients with a History of Paroxysmal Atrial Fibrillation during Sinus Rhythm
title_short Beat-to-Beat P-Wave Analysis Outperforms Conventional P-Wave Indices in Identifying Patients with a History of Paroxysmal Atrial Fibrillation during Sinus Rhythm
title_sort beat-to-beat p-wave analysis outperforms conventional p-wave indices in identifying patients with a history of paroxysmal atrial fibrillation during sinus rhythm
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470012/
https://www.ncbi.nlm.nih.gov/pubmed/34574035
http://dx.doi.org/10.3390/diagnostics11091694
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