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. 2023 Apr 7;11(2):30.
doi: 10.3390/medsci11020030.

Electrocardiographic Predictors of Atrial Fibrillation

Panagiota Anna Chousou  1   2 , Rahul Chattopadhyay  1   2 , Vasiliki Tsampasian  1   3 , Vassilios S Vassiliou  1   3 , Peter John Pugh  2
Affiliations

Electrocardiographic Predictors of Atrial Fibrillation

Panagiota Anna Chousou et al. Med Sci (Basel). .

Abstract

Background: Atrial fibrillation (AF) is the most common pathological arrhythmia, and its complications lead to significant morbidity and mortality. However, patients with AF can often go undetected, especially if they are asymptomatic or have a low burden of paroxysms. Identification of those at high risk of AF development may help refine screening and management strategies.

Methods: PubMed and Embase databases were systematically searched for studies looking at electrocardiographic predictors of AF from inception to August 2021.

Results: A total of 115 studies were reported which examined a combination of atrial and ventricular parameters that could be electrocardiographic predictors of AF. Atrial predictors include conduction parameters, such as the PR interval, p-wave index and dispersion, and partial interatrial or advanced interatrial block, or morphological parameters, such as p-wave axis, amplitude and terminal force. Ventricular predictors include abnormalities in QRS amplitude, morphology or duration, QT interval duration, r-wave progression and ST segment, i.e., t-wave abnormalities.

Conclusions: There has been significant interest in electrocardiographic prediction of AF, especially in populations at high risk of atrial AF, such as those with an embolic stroke of undetermined source. This review highlights the breadth of possible predictive parameters, and possible pathological bases for the predictive role of each parameter are proposed.

Keywords: atrial fibrillation; atrial parameters; prediction; ventricular parameters.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the study selection process.
Figure 2
Figure 2
Stylized V1 p-wave demonstrating certain atrial indices. PWA: p-wave amplitude; PWPT: p-wave peak time; PWD: p-wave duration; PWTF: p-wave terminal force.
Figure 3
Figure 3
Stylized QRS and t-wave demonstrating certain ventricular indices.
Figure 4
Figure 4
Summary of identified electrocardiographic predictors of atrial fibrillation.
See this image and copyright information in PMC

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