Usefulness of P-Wave Duration and Morphologic Variability to Identify Patients Prone to Paroxysmal Atrial Fibrillation

Few data are available on the assessment of P-wave beat-to-beat morphology variability and its ability to identify patients prone to paroxysmal atrial fibrillation (AF) occurrence. Aim of this study was to determine whether electrocardiographic (ECG) parameters resulting from the beat-to-beat analysis of P wave in ECG recorded during sinus rhythm could be indicators of paroxysmal AF susceptibility. ECGs of 76 consecutive patients including 36 patients with history of AF and no overt structural cardiac abnormalities and a control group of 40 healthy patients without history of AF were analyzed. After preprocessing, features based on P waves and RR intervals were extracted from lead II of a 5-minute ECG recorded during sinus rhythm. The discriminative power of the extracted features was assessed. Among extracted features, the most discriminative ones to identify patients with paroxysmal episodes of AF were the mean P-wave duration and the SD of beat-to-beat Euclidean distance between P waves (an indicator of beat-to-beat P-wave morphologic variability). Patients with history of AF presented a significantly longer P-wave duration (125 ± 18 vs 110 ± 8 ms, p