期刊论文

【摘要】

Atrial substrate modification after pulmonary vein isolation (PVI) of paroxysmal atrial fibrillation (pAF) can be assessed non-invasively by analyzing P-wave duration in the electrocardiogram (ECG). However, whether right (RA) and left atrium (LA) contribute equally to this phenomenon remains unknown. The present study splits fundamental P-wave features to investigate the different RA and LA contributions to P-wave duration. Recordings of 29 pAF patients undergoing first-ever PVI were acquired before and after PVI. P-wave features were calculated: P-wave duration ( $P W D$ ), duration of the first ( $P W D_{o n - p e a k}$ ) and second ( $P W D_{p e a k - o f f}$ ) P-wave halves, estimating RA and LA conduction, respectively. P-wave onset ( $P W_{o n} - R$ ) or offset ( $P W_{o f f} - R$ ) to R-peak interval, measuring combined atrial/atrioventricular and single atrioventricular conduction, respectively. Heart-rate fluctuation was corrected by scaling. Pre- and post-PVI results were compared with Mann–Whitney U-test. $P W D$ was correlated with the remaining features. Only $P W D$ (non-scaling: $Δ = - 9.84 %$ , $p = 0.0085$ , scaling: $Δ = - 17.96 %$ , $p = 0.0442$ ) and $P W D_{p e a k - o f f}$ (non-scaling: $Δ = - 22.03 %$ , $p = 0.0250$ , scaling: $Δ = - 27.77 %$ , $p = 0.0268$ ) were decreased. Correlation of all features with $P W D$ was significant before/after PVI ( $p < 0.0001$ ), showing the highest value between $P W D$ and $P W_{o n} - R$ ( $ρ_{m a x} = 0.855$ ). $P W D$ correlated more with $P W D_{o n - p e a k}$ ( $ρ =$ 0.540–0.805) than $P W D_{p e a k - o f f}$ ( $ρ =$ 0.419–0.710). $P W D$ shortening after PVI of pAF stems mainly from the second half of the P-wave. Therefore, noninvasive estimation of LA conduction time is critical for the study of atrial substrate modification after PVI and should be addressed by splitting the P-wave in order to achieve improved estimations.

【授权许可】

Unknown

Sensors
Splitting the P-Wave: Improved Evaluation of Left Atrial Substrate Modification after Pulmonary Vein Isolation of Paroxysmal Atrial Fibrillation

Aurelio Quesada¹ Aikaterini Vraka² José J. Rieta² Fernando Hornero³ Vicente Bertomeu-González⁴ Raúl Alcaraz⁵
[1] Arrhythmia Unit, Cardiology Department, General University Hospital Consortium of Valencia, 46014 Valencia, Spain;BioMIT.org, Electronic Engineering Department, Universitat Politecnica de Valencia, 46022 Valencia, Spain;Cardiovascular Surgery Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain;Clinical Medicine Department, Miguel Hernández University, 03202 Elche, Spain;Research Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, 16071 Cuenca, Spain;
关键词: atrial fibrillation; pulmonary vein isolation; atrial substrate modification; P-wave; left atrium;
DOI : 10.3390/s22010290
来源: DOAJ


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