Key result
Maximum P wave duration is linked to ~5% higher odds of postoperative AF.
Why the study?
It remains unknown whether the mean 24-h pulse rate from ambulatory blood pressure monitoring reflects the mean 24-h ventricular rate from Holter ECG in atrial fibrillation patients.
Do P wave duration metrics and a Gentle AdaBoost algorithm-based ECG predict and detect atrial fibrillation after CABG in elderly patients?
Case-Control (n=106)
No
Do P wave duration metrics and a Gentle AdaBoost algorithm-based ECG predict and detect atrial fibrillation after CABG in elderly patients?
Odds Ratio: 1.047 (95% CI 1.024–1.081)
p-value: p=<0.05
P wave duration parameters (especially Pmax) paired with a Gentle AdaBoost algorithm-based ECG show strong potential in predicting postoperative atrial fibrillation following CABG.
Pmax may aid preoperative AF risk stratification post-CABG; leaves open prospective validation of Gentle AdaBoost ECG models.
BACKGROUND: Ambulatory blood pressure monitoring (ABPM) on the oscillometric method is applicable in patients with atrial fibrillation, but the mean pulse rate is or not similar to the ventricular rate from the Holter in atrial fibrillation patients remains unknown. METHODS: This study included 228 persistent atrial fibrillation patients who received simultaneous 24-h ABPM and 24-h Holter. The mean 24-h pulse rate and the mean 24-h ventricular rate were calculated, and mVR-mPR was used to reflect the difference between them. The SD of 24-h pulse rate values was calculated as SD-pulse rate. Furthermore, according to the SD-pulse rate, the patients were divided into ≤5, 6-10, 11-15 and >15 bpm subgroups. RESULTS: For the total population, the mean 24-h pulse rate is positively correlated with the mean 24-h ventricular rate, and the Bland-Altman plot showed quite wide 95% limits. As the SD-pulse rate increased, the 24-h mVR-mPR also increased. The mean 24-h mVR-mPR was 0.5 bpm when SD-pulse rate ≤5, 3.5 bpm when SD-pulse rate of 6-10, 7.6 bpm when SD-pulse rate of 11-15, and 12.5 bpm when SD-pulse rate >15 bpm, respectively. Meanwhile, in the SD-pulse rate 0-10 subgroup, the 95% limits were only from -13.8 to 19.7 bpm, while in the >10 subgroup, these values were from -19.5 to 36.5 bpm. CONCLUSION: The mean 24-h pulse rate should not be used to represent the true ventricular rate for all atrial fibrillation patients. However, when lower the SD-pulse rate, the mVR-mPR becomes smaller.
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Tong et al. (2020) conducted a case-control in Coronary heart disease post-CABG (n=106). Maximum P wave duration (Pmax) and Gentle AdaBoost algorithm was evaluated on Prediction of postoperative atrial fibrillation (OR 1.047, 95% CI 1.024-1.081, p=<0.05). Maximum P wave duration (Pmax) significantly predicted the occurrence of postoperative atrial fibrillation with an OR of 1.047 (95% CI 1.024-1.081, P<0.05) and an AUC of 0.892.
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