Beat-to-beat P-wave Variability Increases From Paroxysmal to Persistent Atrial Fibrillation

Rita Laureanti*, Stef Zeemering, Matthias D Zink, Valentina D Corino, Angelo Auricchio, Luca T Mainardi, Ulrich Schotten

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingConference article in proceedingAcademicpeer-review


Atrial fibrillation (AF) is known to worsen over time. Beat-to-beat P-wave variability is used to evaluate the risk of developing AF, but it has not been used to monitor arrhythmia progression in a comprehensive model. The aim of this study is to create a method to measure beat-to-beat P-wave variability to evaluate AF types. ECG recordings of 5 minutes were measured on 159 AF patients. The first three principal components (PCs) of the ECG signal were added to the analysis. The temporal beat-to-beat P-wave variability was assessed through the normalized Euclidean Distance and the Similarity Index. The spatial P-wave similarity was measured as the percentage of variance explained by the first 2 PCs. A binomial logistic regression model was built for each lead and parameter, with AF type as dependent variable. To assess variability due exclusively to the P-waves, we considered, as confounding factors, other sources of ECG-variability, such as the noise level, the variability of the RR series and of the heart axis. Both temporal (e.g. 0.94±0.12 for paroxysmal AF and 0.85±0.28 for persistent AF in lead I, p=0.001) and spatial P-wave similarities (95.35±3.29% for paroxysmal AF vs 94.44±4.14% for persistent AF, p=0.001) were significantly higher in paroxysmal than in persistent AF, suggesting them as promising tools to evaluate AF types.
Original languageEnglish
Title of host publication2020 Computing in Cardiology
PublisherIEEE Xplore
Number of pages4
ISBN (Print)978-1-7281-1105-6
Publication statusPublished - 16 Sept 2020
Event2020 Computing in Cardiology - Rimini, Italy
Duration: 13 Sept 202016 Sept 2020


Conference2020 Computing in Cardiology


  • Atrial fibrillation
  • Lead
  • Tools
  • Indexes
  • Monitoring
  • Noise level
  • Logistics

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