Early differentiation of long-standing persistent atrial fibrillation using the characteristics of fibrillatory waves in surface ECG multi-leads

• Published in: Scientific reports Vol. 9; no. 1; p. 2746
• Main Authors: Park, Junbeom, Lee, Chungkeun, Leshem, Eran, Blau, Ira, Kim, Sungsoo, Lee, Jung Myung, Hwang, Jung-A, Choi, Byung-il, Lee, Moon-Hyoung, Hwang, Hye Jin
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 26.02.2019; Nature Publishing Group
• Subjects: 631/57/2266; 692/4019/592/75/29/1309; Atrium; Cardiac arrhythmia; Electrocardiography; Fibrillation; Humanities and Social Sciences; Males; multidisciplinary; Multivariate analysis; Science; Science (multidisciplinary); Waves
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-38928-6

We characterized the f-waves in atrial fibrillation (AF) in the surface ECG by quantifying the amplitude, irregularity, and dominant rate of the f-waves in leads II, aVL, and V 1 , and investigated whether those parameters of the f-waves could discriminate long-standing persistent AF (LPeAF) from non-LPeAF. A total of 224 AF patients were enrolled: 112 with PAF (87 males), 48 with PeAF (38 males), and 64 with LPeAF (47 males). The f-waves in surface ECG leads V 1 , aVL, and II, which reflect well electrical activity in the right atrium (RA), the left atrium (LA), and both atria, respectively, were analyzed. The f-waves for LPeAF had lower amplitudes in II and aVL, increased irregularity and a higher dominant rate in II and V 1 compared to PAF and PeAF (all p < 0.02). In a multivariate analysis, a low amplitude in lead II (<34.6 uV) and high dominant rate in lead V 1 (≧390/min) (p < 0.00 1 ) independently discriminated LPeAF from the other AF types. The f-waves combined with both a low amplitude in lead II and high dominant rate in lead V 1 were significantly associated with LPeAF (OR 6.27, p < 0.001). Characteristics of the f-waves on the surface ECG could discriminate LPeAF from other types of AF.