Post-Stroke Atrial Fibrillation Predicted by P-wave Variability Analysis from a Single-Lead ECG.

Recent evidences suggest that atrial cardiomyopathy is associated with an increased risk of stroke, regardless of the presence of atrial fibrillation (AF).Markers of atrial cardiomyopathy include ECG changes, particularly associated with the P-wave.P-wave analysis is therefore useful in characterizing atrial cardiomyopathy and thus in optimizing the therapeutic pathway of patients, even poststroke.Today, technological advances allow highresolution, beat-by-beat P-wave analysis from single-lead ECG.Patients with ischemic stroke were continuously monitored via ECG for 7 days post-stroke onset.On the second day, a 5-minute high-resolution single-lead ECG trace was recorded for each patient.P-wave parameters, including duration (Pdur), fragmentation (Pfrag), change of polarity (PCP), and beat-to-beat variability (Pvar), were extracted.Patients were divided into AF-detected and control groups, and statistical analysis was performed using the Mann-Whitney test.AF was detected in 15 patients, and all P-wave parameters but Pvar were significantly higher in the AF group than in controls (Pdur: 104.523.3ms vs 133.36.4 ms, Pfrag: 2.281.4vs 3.81.7,PCP: 0.680.6vs 1.30.5).The study showed the potential link between single-lead ECG P-wave analysis and the electrophysiological changes of the atria in post-stroke patients.