P-Wave Morphology Assessment by a Gaussian Functions-Based Model in Atrial Fibrillation Patients

Aim of this study was to present a P-wave model, based on a linear combination of Gaussian functions, to quantify morphological aspects of Pwave in patients prone to atrial fibrillation (AF). Five-minute ECG recordings were performed in 25 patients with permanent dual chamber pacemakers. Patients were divided into high-risk and low-risk groups, including patients with and without AF episodes in the last 6 mo preceding the study, respectively. ECG signals were acquired using a 32-lead mapping system for high-resolution biopotential measurement (ActiveTwo, Biosemi, The Netherlands, sample frequency 2 kHz, 24-bit resolution). Up to 8 Gaussian models have been computed for each averaged P-wave extracted from every lead. The P-wave morphology was evaluated by extracting seven parameters. Classical time-domain parameters, based on P-wave duration estimation, have been also estimated. We found that the P-wave morphology can be effectively modeled by a linear combination of Gaussian functions. In addition, the combination of time-domain and morphological parameters extracted from the Gaussian function-based model of the P-wave improves the identification of patients having different risks of developing AF

[1]  J. Gialafos,et al.  Clinical and Electrocardiographic Predictors of Recurrent Atrial Fibrillation , 2000, Pacing and clinical electrophysiology : PACE.

[2]  J. Gialafos,et al.  Future concepts in P wave morphological analyses. , 2002, Cardiac electrophysiology review.

[3]  Rolf Johansson,et al.  Classification of electrocardiographic P-wave morphology , 2001, IEEE Transactions on Biomedical Engineering.

[4]  L. Jordaens,et al.  Signal-averaged P wave: predictor of atrial fibrillation. , 1998, Journal of cardiovascular electrophysiology.

[5]  J. Gialafos,et al.  P‐Wave Dispersion: A Novel Predictor of Paroxysmal Atrial Fibrillation , 2001, Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc.

[6]  K. Mandal,et al.  Preoperative Electrocardiographic Risk Assessment of Atrial Fibrillation After Coronary Artery Bypass Grafting , 2004, Journal of cardiovascular electrophysiology.

[7]  P A Wolf,et al.  Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. , 1998, The American journal of cardiology.

[8]  S. Sideris,et al.  Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. , 1998, American heart journal.

[9]  L. Epstein,et al.  Use of P wave configuration during atrial tachycardia to predict site of origin. , 1995, Journal of the American College of Cardiology.

[10]  Ying Sun,et al.  Gaussian pulse decomposition: An intuitive model of electrocardiogram waveforms , 1997, Annals of Biomedical Engineering.

[11]  Willis J. Tompkins,et al.  A Real-Time QRS Detection Algorithm , 1985, IEEE Transactions on Biomedical Engineering.

[12]  A. Oto,et al.  P Wave Dispersion on 12‐Lead Electrocardiography in Patients with Paroxysmal Atrial Fibrillation , 2000, Pacing and clinical electrophysiology : PACE.

[13]  T W Simmons,et al.  P wave morphology during atrial pacing along the atrioventricular ring. ECG localization of the site of origin of retrograde atrial activation. , 1996, Journal of electrocardiology.

[14]  Jurandir Nadal,et al.  Spectral turbulence analysis of the signal-averaged electrocardiogram of the atrial activation as predictor of recurrence of idiopathic and persistent atrial fibrillation. , 2006, International journal of cardiology.

[15]  Ioanna Chouvarda,et al.  Can P Wave Wavelet Analysis Predict Atrial Fibrillation After Coronary Artery Bypass Grafting? , 2003, Pacing and clinical electrophysiology : PACE.

[16]  B. Gersh,et al.  P Wave Signal‐Averaged Electrocardiography to Identify Risk for Atrial Fibrillation , 2002, Pacing and clinical electrophysiology : PACE.

[17]  Antonio Michelucci,et al.  P wave assessment: state of the art update. , 2002, Cardiac electrophysiology review.

[18]  S J Evans,et al.  Use of P-wave-triggered, P-wave signal-averaged electrocardiogram to predict atrial fibrillation after coronary artery bypass surgery. , 1995, American heart journal.

[19]  M Fukunami,et al.  Dispersion of signal-averaged P wave duration on precordial body surface in patients with paroxysmal atrial fibrillation. , 1999, European heart journal.

[20]  M. Lesh,et al.  P-wave morphology during right atrial pacing before and after atrial flutter ablation--a new marker for success. , 1997, The American journal of cardiology.

[21]  L. Clavier,et al.  Automatic P-wave analysis of patients prone to atrial fibrillation , 2006, Medical and Biological Engineering and Computing.

[22]  Chris D. Nugent,et al.  Selection of optimal recording sites for limited lead body surface potential mapping: A sequential selection based approach , 2006, BMC Medical Informatics Decis. Mak..

[23]  J. Leclercq,et al.  P Wave Duration and Morphology Predict Atrial Fibrillation Recurrence in Patients with Sinus Node Dysfunction and Atrial‐Based Pacemaker , 2002, Pacing and clinical electrophysiology : PACE.

[24]  A Hansson,et al.  Detection of inter-atrial conduction defects with unfiltered signal-averaged P-wave ECG in patients with lone atrial fibrillation. , 2000, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.