{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:55:20Z","timestamp":1760151320080,"version":"build-2065373602"},"reference-count":80,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T00:00:00Z","timestamp":1647216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003329","name":"Ministry of Economy, Industry and Competitiveness","doi-asserted-by":"publisher","award":["DPI2017-83952-C3","PID2021-00X128525-IV0","PID2021-123804OB-I00","TED2021-129996B-I00"],"award-info":[{"award-number":["DPI2017-83952-C3","PID2021-00X128525-IV0","PID2021-123804OB-I00","TED2021-129996B-I00"]}],"id":[{"id":"10.13039\/501100003329","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Regional Development Fund (EU) - Spanish Government","award":["10.13039\/501100011033"],"award-info":[{"award-number":["10.13039\/501100011033"]}]},{"DOI":"10.13039\/501100003359","name":"Generalitat Valenciana","doi-asserted-by":"publisher","award":["AICO\/2021\/286"],"award-info":[{"award-number":["AICO\/2021\/286"]}],"id":[{"id":"10.13039\/501100003359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Junta de Comunidades Castilla-La Mancha","award":["SB-PLY\/17\/180501\/000411"],"award-info":[{"award-number":["SB-PLY\/17\/180501\/000411"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Since the discovery of pulmonary veins (PVs) as foci of atrial fibrillation (AF), the commonest cardiac arrhythmia, investigation revolves around PVs catheter ablation (CA) results. Notwithstanding, CA process itself is rather neglected. We aim to decompose crucial CA steps: coronary sinus (CS) catheterization and the impact of left and right PVs isolation (LPVI, RPVI), separately. We recruited 40 paroxysmal AF patients undergoing first-time CA and obtained five-minute lead II and bipolar CS recordings during sinus rhythm (SR) before CA (B), after LPVI (L) and after RPVI (R). Among others, duration, amplitude and atrial-rate variability (ARV) were calculated for P-waves and CS local activation waves (LAWs). LAWs features were compared among CS channels for reliability analysis. P-waves and LAWs features were compared after each ablation step (B, L, R). CS channels: amplitude and area were different between distal\/medial (p\u22640.0014) and distal\/mid-proximal channels (p\u22640.0025). Medial and distal showed the most and least coherent values, respectively. Correlation was higher in proximal (\u226593%) than distal (\u226491%) areas. P-waves: duration was significantly shortened after LPVI (after L: p=0.0012,\u00a0\u221213.30%). LAWs: insignificant variations. ARV modification was more prominent in LAWs (L: &gt;+73.12%, p\u22640.0480, R: &lt;\u221233.94%, p\u22640.0642). Medial\/mid-proximal channels are recommended during SR. CS LAWs are not significantly affected by CA but they describe more precisely CA-induced ARV modifications. LPVI provokes the highest impact in paroxysmal AF CA, significantly modifying P-wave duration.<\/jats:p>","DOI":"10.3390\/jpm12030462","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T22:09:58Z","timestamp":1647468598000},"page":"462","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Dissimilar Impact in Atrial Substrate Modificationof Left and Right Pulmonary Veins Isolation after Catheter Ablation of Paroxysmal Atrial Fibrillation"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5984-904X","authenticated-orcid":false,"given":"Aikaterini","family":"Vraka","sequence":"first","affiliation":[{"name":"BioMIT.org, Electronic Engineering Department, Universitat Politecnica de Valencia, 46022 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5309-0562","authenticated-orcid":false,"given":"Vicente","family":"Bertomeu-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Saint John\u2019s University Hospital, 03550 Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1402-4364","authenticated-orcid":false,"given":"Lorenzo","family":"F\u00e1cila","sequence":"additional","affiliation":[{"name":"Cardiology Department, General University Hospital Consortium of Valencia, 46014 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4070-6476","authenticated-orcid":false,"given":"Jos\u00e9","family":"Moreno-Arribas","sequence":"additional","affiliation":[{"name":"Cardiology Department, Saint John\u2019s University Hospital, 03550 Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0942-3638","authenticated-orcid":false,"given":"Ra\u00fal","family":"Alcaraz","sequence":"additional","affiliation":[{"name":"Research Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, 16071 Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3364-6380","authenticated-orcid":false,"given":"Jos\u00e9 J.","family":"Rieta","sequence":"additional","affiliation":[{"name":"BioMIT.org, Electronic Engineering Department, Universitat Politecnica de Valencia, 46022 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,14]]},"reference":[{"key":"ref_1","first-page":"374","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS)","volume":"42","author":"Hindricks","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1056\/NEJM199809033391003","article-title":"Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins","volume":"339","author":"Haissaguerre","year":"1998","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"4109269","DOI":"10.1155\/2021\/4109269","article-title":"The Electrophysiology of Atrial Fibrillation: From Basic Mechanisms to Catheter Ablation","volume":"2021","author":"Ioannidis","year":"2021","journal-title":"Cardiol. Res. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.hlc.2017.05.119","article-title":"Pathophysiology of Paroxysmal and Persistent Atrial Fibrillation: Rotors, Foci and Fibrosis","volume":"26","author":"Lau","year":"2017","journal-title":"Heart Lung Circ."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e005145","DOI":"10.1161\/CIRCEP.117.005145","article-title":"Epicardial Breakthrough Waves During Sinus Rhythm: Depiction of the Arrhythmogenic Substrate?","volume":"10","author":"Mouws","year":"2017","journal-title":"Circ. Arrhythmia Electrophysiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"9147","DOI":"10.1038\/s41598-020-65564-2","article-title":"Specific Electrogram Characteristics Identify the Extra-Pulmonary Vein Arrhythmogenic Sources of Persistent Atrial Fibrillation\u2014Characterization of the Arrhythmogenic Electrogram Patterns During Atrial Fibrillation and Sinus Rhythm","volume":"10","author":"Jadidi","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e017069","DOI":"10.1161\/JAHA.120.017069","article-title":"Simultaneous Endo-Epicardial Mapping of the Human Right Atrium: Unraveling Atrial Excitation","volume":"9","author":"Kharbanda","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1055\/s-2007-1013198","article-title":"Catheter Ablation of Pulmonary Vein Foci for Atrial Fibrillation","volume":"47","author":"Shah","year":"1999","journal-title":"Thorac. Cardiovasc. Surg."},{"key":"ref_9","first-page":"83","article-title":"Pulmonary vein isolation for paroxysmal and persistent atrial fibrillation","volume":"11","author":"Oral","year":"2002","journal-title":"Circulation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2154","DOI":"10.1111\/jce.14638","article-title":"Non-pulmonary vein triggers in nonparoxysmal atrial fibrillation: Implications of pathophysiology for catheter ablation","volume":"31","author":"Tarantino","year":"2020","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_11","first-page":"53","article-title":"Catheter ablation of paroxysmal atrial fibrillation initiated by non-pulmonary vein ectopy","volume":"12","author":"Lin","year":"2003","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"310","DOI":"10.2174\/157340312803760721","article-title":"Triggers and anatomical substrates in the genesis and perpetuation of atrial fibrillation","volume":"8","author":"Pizarro","year":"2012","journal-title":"Curr. Cardiol. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2044","DOI":"10.1016\/j.jacc.2003.12.054","article-title":"A new approach for catheter ablation of atrial fibrillation: Mapping of the electrophysiologic substrate","volume":"43","author":"Nademanee","year":"2004","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Vraka, A., Hornero, F., Bertomeu-Gonz\u00e1lez, V., Osca, J., Alcaraz, R., and Rieta, J.J. (2020). Short-Time Estimation of Fractionation in Atrial Fibrillation with Coarse-Grained Correlation Dimension for Mapping the Atrial Substrate. Entropy, 22.","DOI":"10.3390\/e22020232"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1111\/j.1540-8167.2007.00941.x","article-title":"Biatrial substrate properties in patients with atrial fibrillation","volume":"18","author":"Chang","year":"2007","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"594654","DOI":"10.3389\/fphys.2020.594654","article-title":"Impact of Left Atrial Bipolar Electrogram Voltage on First Pass Pulmonary Vein Isolation During Radiofrequency Catheter Ablation","volume":"11","author":"Garg","year":"2020","journal-title":"Front. Physiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1056\/NEJMoa1408288","article-title":"Approaches to catheter ablation for persistent atrial fibrillation","volume":"372","author":"Verma","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1016\/j.hrthm.2019.03.028","article-title":"Ten-year ablation outcomes of patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation","volume":"16","author":"Cheng","year":"2019","journal-title":"Heart Rhythm"},{"key":"ref_19","first-page":"100717","article-title":"Presence of non-pulmonary vein foci in patients with atrial fibrillation undergoing standard ablation of pulmonary vein isolation: Clinical characteristics and long-term ablation outcome","volume":"32","author":"Inamura","year":"2021","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1016\/0002-9149(82)90471-4","article-title":"Atrial excitability and conduction in patients with interatrial conduction defects","volume":"50","author":"Simpson","year":"1982","journal-title":"Am. J. Cardiol."},{"key":"ref_21","first-page":"198","article-title":"Value of P-wave signal averaging to predict atrial fibrillation recurrences after pulmonary vein isolation","volume":"15","author":"Blanche","year":"2013","journal-title":"EP Eur."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1111\/jce.14070","article-title":"Association between prolonged P wave duration and left atrial scarring in patients with paroxysmal atrial fibrillation","volume":"30","author":"Chen","year":"2019","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e12653","DOI":"10.1111\/anec.12653","article-title":"Prolonged P-wave duration in sinus rhythm pre-ablation is associated with atrial fibrillation recurrence after pulmonary vein isolation\u2014A systematic review and meta-analysis","volume":"24","author":"Pranata","year":"2019","journal-title":"Ann. Noninvasive Electrocardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e018572","DOI":"10.1161\/JAHA.120.018572","article-title":"Short P-Wave Duration is a Marker of Higher Rate of Atrial Fibrillation Recurrences after Pulmonary Vein Isolation: New Insights into the Pathophysiological Mechanisms Through Computer Simulations","volume":"10","author":"Auricchio","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.ijcard.2021.12.036","article-title":"Investigating the association between P wave duration and atrial fibrillation recurrence after radiofrequency ablation in early persistent atrial fibrillation patients","volume":"351","author":"Miao","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_26","first-page":"798","article-title":"Changes in P-wave area and P-wave duration after circumferential pulmonary vein isolation","volume":"12","author":"Houben","year":"2010","journal-title":"EP Eur."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.jelectrocard.2014.04.010","article-title":"Impact of catheter ablation on P-wave parameters on 12-lead electrocardiogram in patients with atrial fibrillation","volume":"47","author":"Maan","year":"2014","journal-title":"J. Electrocardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2616","DOI":"10.12659\/MSM.896675","article-title":"Novel P Wave Indices to Predict Atrial Fibrillation Recurrence After Radiofrequency Ablation for Paroxysmal Atrial Fibrillation","volume":"22","author":"Hu","year":"2016","journal-title":"Med. Sci. Monit."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Vraka, A., Bertomeu-Gonz\u00e1lez, V., Hornero, F., Quesada, A., Alcaraz, R., and Rieta, J.J. (2022). Splitting the P-Wave: Improved Evaluation of Left Atrial Substrate Modification after Pulmonary Vein Isolation of Paroxysmal Atrial Fibrillation. Sensors, 22.","DOI":"10.3390\/s22010290"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1111\/anec.12240","article-title":"The P Wave Time-Frequency Variability Reflects Atrial Conduction Defects before Paroxysmal Atrial Fibrillation","volume":"20","author":"Alcaraz","year":"2015","journal-title":"Ann. Noninvasive Electrocardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1002\/joa3.12604","article-title":"Usefulness of P-wave duration in patients with sick sinus syndrome as a predictor of atrial fibrillation","volume":"37","author":"Murase","year":"2021","journal-title":"J. Arrhythmia"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1536\/ihj.13-231","article-title":"Prolonged PR interval and risk of recurrence of atrial fibrillation after catheter ablation","volume":"55","author":"Wu","year":"2014","journal-title":"Int. Heart J."},{"key":"ref_33","first-page":"519","article-title":"P wave indices to predict atrial fibrillation recurrences post pulmonary vein isolation","volume":"101","author":"Salah","year":"2013","journal-title":"Arq. Bras. Cardiol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.cmpb.2015.01.006","article-title":"Role of the P-wave high frequency energy and duration as noninvasive cardiovascular predictors of paroxysmal atrial fibrillation","volume":"119","author":"Alcaraz","year":"2015","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_35","unstructured":"Task Force of the European Society of Cardiology the North American Society of Pacing Electrophysiologys (1996). Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Eur. Heart J., 17, 354\u2013381."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1111\/jce.12402","article-title":"Heart rate variability findings as a predictor of atrial fibrillation in middle-aged population","volume":"25","author":"Ukkola","year":"2014","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1684","DOI":"10.1016\/j.amjcard.2019.08.025","article-title":"Resting Heart Rate, Short-Term Heart Rate Variability and Incident Atrial Fibrillation (from the Multi-Ethnic Study of Atherosclerosis (MESA))","volume":"124","author":"Habibi","year":"2019","journal-title":"Am. J. Cardiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1161\/01.CIR.100.22.2237","article-title":"Alterations of heart rate variability after radiofrequency catheter ablation of focal atrial fibrillation originating from pulmonary veins","volume":"100","author":"Hsieh","year":"1999","journal-title":"Circulation"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1161\/CIRCRESAHA.114.303772","article-title":"Role of the autonomic nervous system in atrial fibrillation: Pathophysiology and therapy","volume":"114","author":"Chen","year":"2014","journal-title":"Circ. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1111\/jce.14448","article-title":"The predictive value of heart rate variability indices tested in early period after radiofrequency catheter ablation for the recurrence of atrial fibrillation","volume":"31","author":"Zhu","year":"2020","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s10840-019-00576-1","article-title":"Reverse electrical and structural remodeling of the left atrium occurs early after pulmonary vein isolation for persistent atrial fibrillation","volume":"58","author":"Maille","year":"2020","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/0002-9149(94)90102-3","article-title":"Placement of electrode catheters into the coronary sinus during electrophysiology procedures using a femoral vein approach","volume":"74","author":"Daoud","year":"1994","journal-title":"Am. J. Cardiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1161\/01.CIR.98.17.1790","article-title":"Electrical conduction between the right atrium and the left atrium via the musculature of the coronary sinus","volume":"98","author":"Antz","year":"1998","journal-title":"Circulation"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/j.hrthm.2017.02.030","article-title":"Techniques for the provocation, localization, and ablation of non\u2013pulmonary vein triggers for atrial fibrillation","volume":"14","author":"Santangeli","year":"2017","journal-title":"Heart Rhythm"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1159\/000501819","article-title":"Coronary Sinus Ablation Is a Key Player Substrate in Recurrence of Persistent Atrial Fibrillation","volume":"143","author":"Ahmed","year":"2019","journal-title":"Cardiology"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1111\/pace.14026","article-title":"Coronary sinus diverticulum: Importance, function, and treatment","volume":"43","author":"Natale","year":"2020","journal-title":"Pacing Clin. Electrophysiol. PACE"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.4022\/jafib.1809","article-title":"Coronary sinus electrograms may predict new-onset atrial fibrillation after typical atrial flutter radiofrequency ablation","volume":"11","author":"Boles","year":"2018","journal-title":"J. Atr. Fibrillation"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.hrthm.2011.11.041","article-title":"The role of coronary sinus musculature in the induction of atrial fibrillation","volume":"9","author":"Morita","year":"2012","journal-title":"Heart Rhythm"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1536\/ihj.19-584","article-title":"Differential Atrial Pacing to Detect Reconnection Gaps After Pulmonary Vein Isolation in Atrial Fibrillation","volume":"61","author":"Tahara","year":"2020","journal-title":"Int. Heart J."},{"key":"ref_50","first-page":"44","article-title":"Dilation of the coronary sinus on echocardiogram: Prevalence and significance in patients with chronic pulmonary hypertension","volume":"14","author":"Mahmud","year":"2001","journal-title":"JASE"},{"key":"ref_51","first-page":"1259","article-title":"Coronary Sinus Catheter Placement","volume":"124","author":"Langenberg","year":"2003","journal-title":"Clin. Investig. Cardiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1148\/radiol.11102278","article-title":"Posterior interatrial muscular connection between the coronary sinus and left atrium: Anatomic and functional study of the coronary sinus with multidetector CT","volume":"260","author":"Saremi","year":"2011","journal-title":"Radiology"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"D47","DOI":"10.1016\/j.ehjsup.2004.05.024","article-title":"Implantation: Tips and tricks\u2013the cardiologist\u2019s view","volume":"6","author":"Vogt","year":"2004","journal-title":"Eur. Heart J. Suppl."},{"key":"ref_54","first-page":"31","article-title":"Effect of atrial fibrillation on the dynamics of mitral annular area","volume":"12","author":"Pai","year":"2003","journal-title":"J. Heart Valve Dis."},{"key":"ref_55","first-page":"475","article-title":"The coronary sinus conduit function: Anatomical study (relationship to adjacent structures)","volume":"7","author":"Ferrett","year":"2005","journal-title":"EP Eur."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1136\/bmj.324.7335.470","article-title":"ABC of clinical electrocardiography: Introduction. II\u2014basic terminology","volume":"324","author":"Meek","year":"2002","journal-title":"BMJ"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"115006","DOI":"10.1088\/1361-6579\/aae8b1","article-title":"A novel wavelet-based filtering strategy to remove powerline interference from electrocardiograms with atrial fibrillation","volume":"39","author":"Rieta","year":"2018","journal-title":"Physiol. Meas."},{"key":"ref_58","first-page":"1298","article-title":"Electrocardiogram (ECG) Signal Processing","volume":"Volume 2","author":"Laguna","year":"2006","journal-title":"Wiley Encyclopedia of Biomedical Engineering"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"075003","DOI":"10.1088\/1361-6579\/ab2cb8","article-title":"The stationary wavelet transform as an efficient reductor of powerline interference for atrial bipolar electrograms in cardiac electrophysiology","volume":"40","author":"Rieta","year":"2019","journal-title":"Physiol. Meas."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1088\/0967-3334\/29\/12\/001","article-title":"Adaptive singular value cancelation of ventricular activity in single-lead atrial fibrillation electrocardiograms","volume":"29","author":"Alcaraz","year":"2008","journal-title":"Physiol. Meas."},{"key":"ref_61","unstructured":"Mart\u00ednez, A., Alcaraz, R., and Rieta, J.J. (September, January 30). Detection and removal of ventricular ectopic beats in atrial fibrillation recordings via principal component analysis. Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Boston, MA, USA."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"922","DOI":"10.3389\/fphys.2018.00922","article-title":"Quantitative Analysis of the Effect of an Ectopic Beat on the Heart Rate Variability in the Resting Condition","volume":"9","author":"Choi","year":"2018","journal-title":"Front. Physiol."},{"key":"ref_63","unstructured":"Martinez, A., Alcaraz, R., and Rieta, J.J. (September, January 31). A new method for automatic delineation of ECG fiducial points based on the Phasor Transform. Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Buenos Aires, Argentina."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez, F., Alcaraz, R., and Rieta, J.J. (2017, January 24\u201327). Electrocardiographic P-wave delineation based on adaptive slope Gaussian detection. Proceedings of the 2017 Computing in Cardiology (CinC), Rennes, France.","DOI":"10.22489\/CinC.2017.236-033"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Osorio, D., Alcaraz, R., and Rieta, J.J. (2017, January 24\u201327). A fractionation-based local activation wave detector for atrial electrograms of atrial fibrillation. Proceedings of the 2017 Computing in Cardiology (CinC), Rennes, France.","DOI":"10.22489\/CinC.2017.202-031"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Vraka, A., Bertomeu-Gonz\u00e1lez, V., Osca, J., Ravelli, F., Alcaraz, R., and Rieta, J.J. (2020, January 29\u201330). Study on How Catheter Ablation Affects Atrial Structures in Patients with Paroxysmal Atrial Fibrillation: The Case of the Coronary Sinus. Proceedings of the 2020 International Conference on e-Health and Bioengineering (EHB), Iasi, Romania.","DOI":"10.1109\/EHB50910.2020.9280243"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1088\/0967-3334\/33\/6\/969","article-title":"Short-time regularity assessment of fibrillatory waves from the surface ECG in atrial fibrillation","volume":"33","author":"Alcaraz","year":"2012","journal-title":"Physiol. Meas."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.31083\/j.rcm2204170","article-title":"The P wave dispersion\u2014One pixel, one millisecond","volume":"22","author":"Zawadzki","year":"2021","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2551","DOI":"10.1038\/s41598-020-59480-8","article-title":"Physiologic heart rate dependency of the PQ interval and its sex differences","volume":"10","author":"Toman","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_70","first-page":"80","article-title":"Contributions to Probability and Statistics: Essays in Honor of Harold Hotelling","volume":"3","author":"Mandelbrot","year":"1961","journal-title":"Siam Rev."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1093\/biomet\/52.3-4.591","article-title":"An Analysis of Variance Test for Normality (Complete Samples)","volume":"52","author":"Shapiro","year":"1965","journal-title":"Biometrika"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1080\/01621459.1952.10483441","article-title":"Use of ranks in one-criterion variance analysis","volume":"47","author":"Kruskal","year":"1952","journal-title":"J. Am. Stat. Assoc."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1214\/aoms\/1177730491","article-title":"On a Test of Whether one of Two Random Variables is Stochastically Larger than the Other","volume":"18","author":"Mann","year":"1947","journal-title":"Ann. Math. Stat."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1046\/j.1540-8167.2003.03222.x","article-title":"Role of the coronary sinus in maintenance of atrial fibrillation","volume":"14","author":"Oral","year":"2003","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1016\/j.hrthm.2013.06.007","article-title":"Characteristics of atrial fibrillation cycle length predict restoration of sinus rhythm by catheter ablation","volume":"10","author":"Raine","year":"2013","journal-title":"Heart Rhythm"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1002\/bem.22115","article-title":"Heart rate variability affected by radiofrequency electromagnetic field in adolescent students","volume":"39","author":"Misek","year":"2018","journal-title":"Bioelectromagnetics"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"633","DOI":"10.33549\/physiolres.934425","article-title":"Radiofrequency Electromagnetic Field Affects Heart Rate Variability in Rabbits","volume":"69","author":"Misek","year":"2020","journal-title":"Physiol. Res."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"102500","DOI":"10.1016\/j.bspc.2021.102500","article-title":"Variation of P-wave indices in paroxysmal atrial fibrillation patients before and after catheter ablation","volume":"66","author":"Ortigosa","year":"2021","journal-title":"Biomed. Signal Process. Control"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"654053","DOI":"10.3389\/fphys.2021.654053","article-title":"ECG-Based Indices to Characterize Persistent Atrial Fibrillation Before and During Stepwise Catheter Ablation","volume":"12","author":"McCann","year":"2021","journal-title":"Front. Physiol."},{"key":"ref_80","first-page":"271","article-title":"Left atrial anatomy, atrial fibrillation burden, and P-wave duration\u2014Relationships and predictors for single-procedure success after pulmonary vein isolation","volume":"20","author":"Knecht","year":"2018","journal-title":"EP Eur."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/3\/462\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:36:05Z","timestamp":1760135765000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/3\/462"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,14]]},"references-count":80,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["jpm12030462"],"URL":"https:\/\/doi.org\/10.3390\/jpm12030462","relation":{},"ISSN":["2075-4426"],"issn-type":[{"type":"electronic","value":"2075-4426"}],"subject":[],"published":{"date-parts":[[2022,3,14]]}}}