Can P wave wavelet analysis predict atrial fibrillation after coronary artery bypass grafting?

Pacing Clin Electrophysiol. 2003 Jan;26(1P2):305-9. doi: 10.1046/j.1460-9592.2003.00038.x.

Abstract

The purpose of this study was the evaluation of Morlet wavelet analysis of the P wave as a means of predicting the development of atrial fibrillation (AF) in patients who undergo coronary artery bypass grafting (CABG). The P wave was analyzed using the Morlet wavelet in 50 patients who underwent successful CABG. Group A consisted of 17 patients, 12 men and 5 women, of mean age 66.9 +/- 5.9 years, who developed AF postoperatively. Group B consisted of 33 patients, 29 men and 4 women, mean age 62.4 +/- 7.8 years, who remained arrhythmid-free. Using custom-designed software, P wave duration and wavelet parameters expressing the mean and maximum energy of the P wave were calculated from 3-channel digital recordings derived from orthogonal ECG leads (X, Y, and Z), and the vector magnitude (VM) was determined in each of 3 frequency bands (200-160 Hz, 150-100 Hz and 90-50 Hz). Univariate logistic-regression analysis identified a history of hypertension, the mean and maximum energies in all frequency bands along the Z axis, the mean and maximum energies (expressed by the VM) in the 200-160 Hz frequency band, and the mean energy in the 150-100 Hz frequency band along the Y axis as predictors for post-CABG AF. Multivariate analysis identified hypertension, ejection fraction, and the maximum energies in the 90-50 Hz frequency band along the Z and composite-vector axes as independent predictors. This multivariate model had a sensitivity of 91% and a specificity of 65%. We conclude that the Morlet wavelet analysis of the P wave is a very sensitive method of identifying patients who are likely to develop AF after CABG. The occurrence of post-CABG AF can be explained by a different activation pattern along the Z axis.

MeSH terms

  • Aged
  • Atrial Fibrillation / diagnosis*
  • Atrial Fibrillation / etiology
  • Coronary Artery Bypass / adverse effects*
  • Electrocardiography*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • Sensitivity and Specificity
  • Signal Processing, Computer-Assisted*