Fibrillatory wave size in paroxysmal atrial fibrillation

Little attention has been paid to the atrial fibrillatory waves (f waves) in paroxysmal atrial fibrillation. The present study attempted (1) to compare the f wave size in paroxysmal atrial fibrillation with that in persistent fibrillation, and (2) to examine whether the f wave size can predict the development of persistent from paroxysmal atrial fibrillation. The size of the f waves was measured in 60 patients with paroxysmal atrial fibrillation of non-rheumatic etiology (group A), 87 patients with persistent atrial fibrillation of non-rheumatic etiology (group B), and 34 patients with persistent atrial fibrillation of rheumatic etiology (group C). The f wave size in group A was 1.1 +/- 0.1 mm (mean +/- SE) which was significantly smaller than 1.6 +/- 0.1 mm in group B and 2.2 +/- 0.2 mm in group C (p less than 0.01, respectively). Among patients with paroxysmal atrial fibrillation, persistent atrial fibrillation developed in 9 of 19 patients (47.4%) with f wave size of 1.2 mm or more, and only in 5 of 41 patients (12.2%) with f wave size of less than 1.2 mm. These results indicate that paroxysmal atrial fibrillation generally has smaller f waves than persistent atrial fibrillation, but that the presence of larger f waves indicates potential development of persistent atrial fibrillation.