Why the study?
To evaluate the hypothesis that slower atrial conduction and atrial myocardial fibrosis lead to widened, more complex, and more rugose P waves in atrial fibrillation.
P-wave morphology becomes significantly wider and more complex in the minutes preceding an episode of paroxysmal atrial fibrillation, suggesting progressive de-structuring of the atrial wavefront.
P-wave rugosity may reflect atrial remodeling in PxAF; leaves open prospective validation before any clinical use.
Atrial fibrillation (AF) is the most frequent arrhythmia in clinical practice. It usually initiates as a paroxysmal activity (PxAF), with the subject having sinus rhythm, with interleaved AF episodes. The objective of the study is to evaluate the observations made by Pyotr Platonov, who hypothesized that slower conduction in the atria and the presence of fibrosis in the atrial myocardium, both associated to AF, lead to P waves widened, more complex and with increased rugosity. The study shows that P wave morphology significantly changes prior to the onset of AF episodes in PxAF, increasing the variability, making more complex P-wave loop, and enlarging the duration, which can be attributed to the de-structuring of the atrial wavefront.
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Aramburu et al. (2022) studied this question.
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