Abstract 14396: Characterizing Pulse Deficits in Atrial Fibrillation Using Simple ECG Features

IntroductionAtrial fibrillation can cause pulse deficits, or absence of a pulse wave following ventricular depolarization. We sought to characterize pulse deficits based on ECG features and correlate presence of pulse deficits with clinical characteristics, such as symptom severity and findings on cardiac imaging.MethodsData was collected from patients having radiofrequency ablation. 60s epochs of 12-lead surface ECG and radial intra-arterial blood pressure were extracted. RR intervals (RRI) were calculated using Pan-Tompkins algorithm. Pulse deficits were identified using intra-arterial blood pressure and defined as a wave with pulse pressure < 20% mean pulse pressure. The preceding RRI was defined as S, and the pre-preceding RRI was defined as L. RRIs associated with normal pulses were also calculated. Multivariable logistic regression was used to assess detection capabilities of ECG features. Patients with and without pulse deficits were compared on symptom severity (CCS AF, Mayo Symptom Severity Index) and findings on cardiac MRI.ResultsEighteen patients had pulse deficits while 26 patients had none. In total, 628 pulse deficits were observed with L (621±194ms) greater than S (438±54.5ms) (p