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P-Wave Morphological Variability Exacerbation Prior to Atrial Fibrillation Episodes

Noriega, Maikel ; Martín-Yebra, Alba ; Savelev, Aleksei LU orcid ; Platonov, Pyotr LU ; Marta, Javier ; Butkuviene, Monika ; Martínez, Juan Pablo and Laguna, Pablo (2025) 52nd International Computing in Cardiology, CinC 2025 52.
Abstract

This study analyzes the temporal evolution of the short-term P-wave morphological variability (PWMV) within the one-hour interval immediately preceding the onset of atrial fibrillation (AF) episodes. This PWMV is hypothesized to be an index of vulnerable atrial substrate, allowing to identify instability increases preceding the AF episode onset. We analyzed 32 ambulatory ECG recordings from subjects with paroxysmal AF. For each i-th subject and j-th AF episode, the PWMV was characterized in consecutive 2-min windows (k = 1 . . . 30) within the last 60 min before the AF onset. For each 2-min window, the median absolute deviation (MAD) of the P wave signals pi,j,kMAD(n); and the MAD energy normalized to the median of... (More)

This study analyzes the temporal evolution of the short-term P-wave morphological variability (PWMV) within the one-hour interval immediately preceding the onset of atrial fibrillation (AF) episodes. This PWMV is hypothesized to be an index of vulnerable atrial substrate, allowing to identify instability increases preceding the AF episode onset. We analyzed 32 ambulatory ECG recordings from subjects with paroxysmal AF. For each i-th subject and j-th AF episode, the PWMV was characterized in consecutive 2-min windows (k = 1 . . . 30) within the last 60 min before the AF onset. For each 2-min window, the median absolute deviation (MAD) of the P wave signals pi,j,kMAD(n); and the MAD energy normalized to the median of the P wave energy in each subject Eri,j(k) were measured. Then, for each subject, a normalized median across AF episodes was obtained, Ẽri(k). A two-segment linear function fit of Ẽr(k) temporal evolution, by least squares error (LSE) minimization was used to characterize the cohort dynamics. Analyzing the cohort dynamics of Ẽr(k), a relative stability can be observed up to 8 minutes before the AF episode onset, when Ẽr(k) value starts increasing. In conclusion, PWMV can be monitored by quantifying the P-wave short-time MAD relative energy, which shows an increasing trend within the 8 minutes previous to the AF onset.

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author
; ; ; ; ; ; and
organization
publishing date
type
Chapter in Book/Report/Conference proceeding
publication status
published
subject
host publication
Computing in Cardiology
volume
52
conference name
52nd International Computing in Cardiology, CinC 2025
conference location
Sao Paulo, Brazil
conference dates
2025-09-14 - 2025-09-17
external identifiers
  • scopus:105028521864
DOI
10.22489/CinC.2025.084
language
English
LU publication?
yes
id
2f1e78ef-600a-46f6-860e-59028f51d068
date added to LUP
2026-02-27 08:52:10
date last changed
2026-02-27 08:52:20
@inproceedings{2f1e78ef-600a-46f6-860e-59028f51d068,
  abstract     = {{<p>This study analyzes the temporal evolution of the short-term P-wave morphological variability (PWMV) within the one-hour interval immediately preceding the onset of atrial fibrillation (AF) episodes. This PWMV is hypothesized to be an index of vulnerable atrial substrate, allowing to identify instability increases preceding the AF episode onset. We analyzed 32 ambulatory ECG recordings from subjects with paroxysmal AF. For each i-th subject and j-th AF episode, the PWMV was characterized in consecutive 2-min windows (k = 1 . . . 30) within the last 60 min before the AF onset. For each 2-min window, the median absolute deviation (MAD) of the P wave signals p<sup>i,j,k</sup><sub>MAD</sub>(n); and the MAD energy normalized to the median of the P wave energy in each subject E<sub>r</sub><sup>i,j</sup>(k) were measured. Then, for each subject, a normalized median across AF episodes was obtained, Ẽ<sub>r</sub><sup>i</sup>(k). A two-segment linear function fit of Ẽ<sub>r</sub>(k) temporal evolution, by least squares error (LSE) minimization was used to characterize the cohort dynamics. Analyzing the cohort dynamics of Ẽ<sub>r</sub>(k), a relative stability can be observed up to 8 minutes before the AF episode onset, when Ẽ<sub>r</sub>(k) value starts increasing. In conclusion, PWMV can be monitored by quantifying the P-wave short-time MAD relative energy, which shows an increasing trend within the 8 minutes previous to the AF onset.</p>}},
  author       = {{Noriega, Maikel and Martín-Yebra, Alba and Savelev, Aleksei and Platonov, Pyotr and Marta, Javier and Butkuviene, Monika and Martínez, Juan Pablo and Laguna, Pablo}},
  booktitle    = {{Computing in Cardiology}},
  language     = {{eng}},
  title        = {{P-Wave Morphological Variability Exacerbation Prior to Atrial Fibrillation Episodes}},
  url          = {{http://dx.doi.org/10.22489/CinC.2025.084}},
  doi          = {{10.22489/CinC.2025.084}},
  volume       = {{52}},
  year         = {{2025}},
}