P‐Wave Signal‐Averaged Electrocardiogram Predicts Atrial Fibrillation After Coronary Artery Bypass Grafting

Caravelli, Paolo; Musumeci, Giuseppe; Tartarini, Giuseppe; Gherarducci, G; Bortolotti, Uberto; Mariani, Massimo A.; Mariani, A.

doi:10.1111/j.1542-474x.2002.tb00163.x

Cited by 15 publications

(30 citation statements)

References 29 publications

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“…While recording just lead II of the standard 12-lead ECG only (demanding two electrodes only), the achieved quality of AF prediction (table 5) was comparable to the SAECG studies (table 2) in which the three orthogonal leads of vectorcardiography (ideally demanding seven electrodes) were involved (Aytemir et al 1999, Caravelli et al 2002, Klein et al 1995, Stafford et al 1997, Steinberg et al 1993, Vassilikos et al 2003, Zaman et al 1997. A more strict and faithful comparison of methods for post-operative AF prediction could be done in a project in a future by making our database available to other investigator groups.…”

Section: Discussionmentioning

confidence: 87%

“…Several studies have suggested that the duration of a filtered signal averaged P wave can be an independent predictor of post-operative AF (Aytemir et al 1999, Caravelli et al 2002, Klein et al 1995, Stafford et al 1997, Steinberg et al 1993, Vassilikos et al 2003, Zaman et al 1997. However, no consensus was reached for the classification based on the P wave prolongation, and stated threshold levels spanned the range from 122 to 155 ms.…”

Section: Discussionmentioning

confidence: 99%

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ECG-based prediction of atrial fibrillation development following coronary artery bypass grafting

Sovilj¹,

Oosterom²,

Rajsman³

et al. 2010

Physiol. Meas.

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In patients undergoing coronary artery bypass grafting (CABG) surgery, postoperative atrial fibrillation (AF) occurs with a prevalence of up to 40%. The highest incidence is seen between the second and third day after the operation. Following cardiac surgery AF may cause various complications such as hemodynamic instability, heart attack and cerebral or other thromboembolisms. AF increases morbidity, duration and expense of medical treatments. This study aims at identifying patients at high risk of post-operative AF. Early prediction of AF would provide timely prophylactic treatment and would reduce the incidence of arrhythmia. Patients at low risk of post-operative AF could be excluded on the basis of the contraindications of anti-arrhythmic drugs. The study included 50 patients in whom lead II electrocardiograms were continuously recorded for 48 h following CABG. Univariate statistical analysis was used in the search for signal features that could predict AF. The most promising ones identified were P wave duration, RR interval duration and PQ segment level. On the basis of these, a nonlinear multivariate prediction model was made by deploying a classification tree. The prediction accuracy was found to increase over time. At 48 h following CABG, the measured best smoothed sensitivity was 84.8% and the specificity 85.4%. The positive and negative predictive values were 72.7% and 92.8%, respectively, and the overall accuracy was 85.3%. With regard to the prediction accuracy, the risk assessment 4 Author to whom any correspondence should be addressed. and prediction of post-operative AF is optimal in the period between 24 and 48 h following CABG.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

ECG-based prediction of atrial fibrillation development following coronary artery bypass grafting

Sovilj¹,

Oosterom²,

Rajsman³

et al. 2010

Physiol. Meas.

View full text Add to dashboard Cite

show abstract

“…An analysis of lead II P-wave duration and P-terminal force in a standard ECG has been reported to show no significant difference in any of these variables between AF patients and non-AF patients after CABG. 27,29 Changes in heart rate variability before postoperative AF have already been documented, yet Hakala and coworkers 30 showed that a short-term preoperative analysis of heart rate variability under standardized physiological conditions could not reliably identify patients at high risk of AF after CABG.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Atrial Fibrillation via Atrial Electromechanical Interval After Coronary Artery Bypass Grafting

et al. 2007

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Background-We assessed the validity of the atrial electromechanical interval, measured by transthoracic tissue Doppler echocardiography, in determining patients at risk of post-coronary artery bypass graft atrial fibrillation (AF). Methods and Results-This prospective study recruited 355 patients in sinus rhythm who were candidates for coronary artery bypass grafting. The patients underwent a preoperative transthoracic echocardiography with a tissue Doppler evaluation and were monitored with continuous ECG telemetry during their hospital stay. Sixty-eight patients had postoperative AF (19.2%), with the incident occurring 2.3Ϯ0.7 days after surgery. The median length of hospitalization was 7.0 days for the AF patients and 6.0 days for the non-AF patients (PϽ0.0001). The subjects with postoperative AF differed from the sinus rhythm patients in that the former had a lower ejection fraction (40.4Ϯ8.5% versus 48.4Ϯ9.4%), a reduced maximal A-wave transmitral Doppler flow velocity (44.3Ϯ4.6 versus 53.3Ϯ10.9 cm/s), an increased total atrial volume (68.7Ϯ12.6 versus 55.3Ϯ11.8 mL), and a prolonged atrial electromechanical interval (141.9Ϯ13.4 versus 100.3Ϯ10.3 ms, respectively; PϽ0.0001 for all). In addition, the AF patients were older than the sinus rhythm group (66.0Ϯ8.0 versus 59.8Ϯ8.5 years). The atrial electromechanical interval was the best independent discriminator of the history of AF. We defined a cutoff point for the atrial electromechanical interval and chose 120 milliseconds for categorization, which yielded 100% sensitivity and 94.8% specificity for the prediction of AF. Conclusions-The atrial electromechanical interval by transthoracic tissue Doppler echocardiography could be a valuable method for identifying patients vulnerable to post-coronary artery bypass graft AF.

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“…There are large differences between the results of similar studies [6][7][8][9]20,21] regarded to FPD and COP. We found a COP with a FPD of 124 ms and a RMS 20 of 3.7 AV as the best predictive value for AF after CABG.…”

Section: P Wave Signal Averaged Ecgmentioning

confidence: 50%

Prediction of atrial fibrillation after coronary artery bypass grafting: The role of chemoreflexsensitivity and P wave signal averaged ECG

Budeus

Hennersdorf

Röhlen

et al. 2006

International Journal of Cardiology

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P‐Wave Signal‐Averaged Electrocardiogram Predicts Atrial Fibrillation After Coronary Artery Bypass Grafting

Abstract: Preoperative SAECG is a simple exam that correctly identifies patients at higher risk of AF after CABG. A more widespread use of this technique can be suggested.

Cited by 15 publications

References 29 publications

ECG-based prediction of atrial fibrillation development following coronary artery bypass grafting

ECG-based prediction of atrial fibrillation development following coronary artery bypass grafting

Prediction of Atrial Fibrillation via Atrial Electromechanical Interval After Coronary Artery Bypass Grafting

Prediction of atrial fibrillation after coronary artery bypass grafting: The role of chemoreflexsensitivity and P wave signal averaged ECG

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