title: Surface ECG f Wave Analysis at Initial Onset of Paroxysmal and Persistent Atrial Fibrillation.
abstract: BACKGROUND
  Dominant frequency (DF) analysis of electrocardiograms (ECGs) from patients with paroxysmal (PAF) and persistent (PeAF) atrial fibrillation has identified higher DFs in PeAF. We therefore hypothesized that among patients initially presenting to the emergency department (ED) with new onset AF, surface ECG features could differentiate PeAF from PAF.
  
  
  RESULTS
  Initial 12-lead ECGs from patients presenting to the ED with a first episode of symptomatic AF were analyzed. Following QRS-T subtraction, fast Fourier transform (FFT) analysis of the AF fibrillatory waves was performed to measure DF and organization index (OI). Median DF of all leads and the DF in the lead with maximum OI were determined. Maximum f wave amplitude and vector magnitudes were measured. One hundred sixty-one patients (age 59 ± 16 years, 68% men) were included in this analysis, of whom 96 (58%) spontaneously converted to sinus rhythm within 7 days (PAF group). The remaining 65 patients underwent cardioversion or remained in AF (PeAF group). ECG features (DF, OI, f wave amplitude, and vector magnitude) did not differ among PAF and PeAF patients.
  
  
  CONCLUSIONS
  ECG features (DF, OI, amplitude, vector magnitude) do not differ among patients with PAF versus PeAF when the ECGs are obtained at the initial onset of symptoms. Thus, prior data showing higher DF in PeAF likely reflect electrophysiologic remodeling rather than a marker for any specific type of AF or extent of underlying substrate.
authors.affiliation: Feinberg School of Medicine, Northwestern University, USA.
authors.forename: Parth
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Tyler W
authors.initials: TW
authors.lastname: Barrett
authors.affiliation: Center for Cardiovascular Innovation and the Division of Cardiology, Feinberg School of Medicine, Northwestern University, Illinois, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Ng
authors.affiliation: Center for Cardiovascular Innovation and the Division of Cardiology, Feinberg School of Medicine, Northwestern University, Illinois, USA.
authors.forename: Claire
authors.initials: C
authors.lastname: Knoten
authors.affiliation: Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Allison J
authors.initials: AJ
authors.lastname: Ferreira
authors.affiliation: Center for Cardiovascular Innovation and the Division of Cardiology, Feinberg School of Medicine, Northwestern University, Illinois, USA.|Miller School of Medicine, University of Miami, Florida, USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Goldberger
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D005583:Fourier Analysis; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D007087:Illinois; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012815:Signal Processing, Computer-Assisted; D013714:Tennessee
keywords: ECG; atrial fibrillation; dominant frequency; emergency department; paroxysmal atrial fibrillation; persistent atrial fibrillation