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The P wave time-frequency variability reflects atrial conduction defects before paroxysmal atrial fibrillation

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The P wave time-frequency variability reflects atrial conduction defects before paroxysmal atrial fibrillation

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Nombre: -R. Alcaraz;A. ...
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dc.contributor.author Alcaraz, Raúl es_ES
dc.contributor.author Martínez, Arturo es_ES
dc.contributor.author Rieta, J J es_ES
dc.date.accessioned 2016-05-21T08:34:18Z
dc.date.available 2016-05-21T08:34:18Z
dc.date.issued 2015-09
dc.identifier.issn 1082-720X
dc.identifier.uri http://hdl.handle.net/10251/64528
dc.description.abstract BackgroundThe study of atrial conduction defects associated with the onset of paroxysmal atrial fibrillation (PAF) can be addressed by analyzing the P wave from the surface electrocardiogram (ECG). Traditionally, signal-averaged ECGs have been mostly used for this purpose. However, this alternative hinders the possibility to quantify every single P wave, its variability over time, as well as to obtain complimentary and evolving information about the arrhythmia. This work analyzes the time progression of several time and frequency P wave features as potential indicators of atrial conduction variability several hours preceding the onset of PAF. MethodsThe longest sinus rhythm interval from 24-hour Holter recordings of 46 PAF patients was selected. Next, the 2 hours before the onset of PAF were extracted and divided into two 1-hour periods. Every single P wave was automatically delineated and characterized by 16 time and frequency metrics, such as its duration, absolute energy in several frequency bands and high-to-low-frequency energy ratios. Finally, the P wave variability over each 1-hour period was estimated from the 16 features making use of a least-squares linear fitting. As a reference, the same parameters were also estimated from a set of 1-hour ECG segments randomly chosen from a control group of 53 healthy subjects age-, gender-, and heart rate-matched. ResultsAll the analyzed metrics provided an increasing P wave variability trend as the onset of PAF approximated, being P wave duration and P wave high-frequency energy the most significant individual metrics. The linear fitting slope associated with P wave duration was (2.48 1.98)x10(-2) for healthy subjects, (23.8 +/- 14.1)x10(-2)for ECG segments far from PAF and for (81.8 +/- 48.7)x10(-2)ECG segments close to PAF p = 6.96x10(-22). Similarly, the P wave high-frequency energy linear fitting slope was (2.42 +/- 4.97)x10(-9), (54.2 +/- 107.1)x10(-9) and (274.2 +/- 566.1)x10(-9), respectively (p = 2.85x10(-20)). A univariate discriminant analysis provided that both P wave duration and P wave high-frequency energy could discern among the three ECG sets with diagnostic ability around 80%, which was improved up to 88% by combining these metrics in a multivariate discriminant analysis. ConclusionAlterations in atrial conduction can be successfully quantified several hours before the onset of PAF by estimating variability over time of several time and frequency P wave features. es_ES
dc.description.sponsorship Work supported by the project PPII11-0194-8121 from Junta de Comunidades de Castilla La Mancha. The authors are grateful to cardiologists Fernando Hornero, Lorenzo Facila, and Federico Paredes, from the Cardiac University Hospital of Valencia, for their valuable assistance in the inspection of the ECG recordings. en_EN
dc.language Inglés es_ES
dc.publisher Wiley: 12 months es_ES
dc.relation.ispartof Annals of Noninvasive Electrocardiology es_ES
dc.rights Reserva de todos los derechos es_ES
dc.subject Atrial conduction es_ES
dc.subject Paroxysmal atrial fibrillation es_ES
dc.subject Surface P wave es_ES
dc.subject Time and frequency analysis es_ES
dc.subject.classification TECNOLOGIA ELECTRONICA es_ES
dc.title The P wave time-frequency variability reflects atrial conduction defects before paroxysmal atrial fibrillation es_ES
dc.type Artículo es_ES
dc.identifier.doi 10.1111/anec.12240
dc.relation.projectID info:eu-repo/grantAgreement/JCCM//PPII11-0194-8121/ es_ES
dc.rights.accessRights Cerrado es_ES
dc.contributor.affiliation Universitat Politècnica de València. Departamento de Ingeniería Electrónica - Departament d'Enginyeria Electrònica es_ES
dc.description.bibliographicCitation Alcaraz, R.; Martínez, A.; Rieta, JJ. (2015). The P wave time-frequency variability reflects atrial conduction defects before paroxysmal atrial fibrillation. Annals of Noninvasive Electrocardiology. 20(5):433-445. https://doi.org/10.1111/anec.12240 es_ES
dc.description.accrualMethod S es_ES
dc.relation.publisherversion http://dx.doi.org/10.1016/10.1111/anec.12240 es_ES
dc.description.upvformatpinicio 433 es_ES
dc.description.upvformatpfin 445 es_ES
dc.type.version info:eu-repo/semantics/publishedVersion es_ES
dc.description.volume 20 es_ES
dc.description.issue 5 es_ES
dc.relation.senia 302086 es_ES
dc.contributor.funder Junta de Comunidades de Castilla-La Mancha es_ES
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