Surface ECG f Wave Analysis at Initial Onset of Paroxysmal and Persistent Atrial Fibrillation

Parth Sharma, Tyler W. Barrett, Jason Ng, Claire Knoten, Allison J. Ferreira, Jeffrey J. Goldberger*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Introduction: 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. Methods and 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.

Original languageEnglish (US)
Pages (from-to)498-503
Number of pages6
JournalJournal of cardiovascular electrophysiology
Issue number5
StatePublished - May 2017


  • ECG
  • atrial fibrillation
  • dominant frequency
  • emergency department
  • paroxysmal atrial fibrillation
  • persistent atrial fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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