Key result
Atrial pacing prolonged and increased the morphological complexity of the P wave compared to sinus rhythm, with greater changes observed in patients at lower risk for atrial fibrillation.
Why the study?
Does atrial pacing alter time-domain and morphological descriptors of the P wave compared to spontaneous rhythm in patients with paroxysmal AF?
Cross-Sectional (n=19)
Does atrial pacing alter time-domain and morphological descriptors of the P wave compared to spontaneous rhythm in patients with paroxysmal AF?
Atrial pacing prolongs and increases the morphological complexity of the P wave, masking baseline differences in P wave descriptors that otherwise distinguish patients with and without recent AF episodes.
Pacing may mask P-wave AF risk markers in clinical recordings; leaves open need for rhythm-specific validation in prospective cohorts.
BACKGROUND: The aim of this study was to compare time-domain and morphological descriptors of paced and spontaneous P wave in patients prone to atrial fibrillation (AF). METHODS: Nineteen patients (nine women, aged 72 +/- 10 years) affected by paroxysmal AF and implanted with dual-chamber pacemakers (PM) were studied. Two 5-minute recordings were performed during spontaneous and paced rhythm. Electrocardiogram (ECG) signals were acquired using a 32-lead mapping system. Patients were grouped into two classes: no previous AF and previous AF groups, according to the number of AF episodes in the 6 months before the analysis. RESULTS AND CONCLUSION: During atrial pacing P wave appeared prolonged and morphologically more complex with respect to sinus rhythm. We also found that in patients at lower risk for AF, the atrial pacing changes the atrial activation to a greater extent than in patients at higher risk for AF. Finally, all time-domain and morphological descriptors of the P wave except one succeed in discriminating "no previous AF" and "previous AF" patients in spontaneous rhythm, while no significant differences have been observed during pacing for any parameters.
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Censi et al. (2008) conducted a cross-sectional in Paroxysmal atrial fibrillation (n=19). Atrial pacing vs. Spontaneous rhythm (sinus rhythm) was evaluated on Time-domain and morphological descriptors of the P wave. Atrial pacing prolonged and increased the morphological complexity of the P wave compared to sinus rhythm, with greater changes observed in patients at lower risk for atrial fibrillation.
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