TY - JOUR
T1 - Signal-averaged P-wave ECG discriminates between persistent and paroxysmal atrial fibrillation
AU - Santoni-Rugiu, Francesco
AU - Verma, Rajiv
AU - Mehta, Davendra
AU - Gopal, Aasha
AU - Chan, Eric K.Y.
AU - Pe, Elena
AU - Gomes, J. Anthony
PY - 2001
Y1 - 2001
N2 - Atrial fibrillation (Afib) has been associated with abnormal signal-averaged P wave (SAPW) parameters but whether SAPW is associated with the time course of these arrhythmias (persistent vs. paroxysmal, frequent vs. rare episodes) remains unknown. This article assesses the significance of SAPW duration in distinguishing patients with paroxysmal from those with persistent Afib. SAPW electrocardiogram was performed with a "double triggering" software system for acquisition and analysis of data. SAPW total duration (TD), X, Y, and Z leads magnitudes and vector signal magnitudes were measured offline. Optimal cutoff value between control and patient groups was determined by using a receiver operator characteristic curve. Data were analyzed to compare controls with patients groups and between patient groups according to time course of the arrhythmic history. Fifteen age-matched patients without a history of Afib and 55 patients with a history of Afib (33 with paroxysmal and 22 with persistent arrhythmia) were studied off antiarrhythmic drugs. Patients with history of persistent arrhythmia were studied within 2 days after electrical cardioversion to sinus rhythm. SAPW TD was the only parameter consistently associated with Afib. SAPW TD was 98 ± 6 ms (mean ± SD) in the control group, 127 ± 19 ms in the pooled patients group (P =.0001); 122 ± 20 ms for paroxysmal and 133 ± 17 ms for the persistent Afib group (P =.04). Analysis of other SAPW parameters were not statistically significant. SAPW duration is a simple method to identify patients with history of Afib. A significantly longer SAPW TD characterizes patients with a history of persistent as opposed to paroxysmal Afib. Prolongation of SAPW TD possibly reflects more advanced electrophysiological changes, creating a more stable substrate that leads to persistence of the arrhythmia.
AB - Atrial fibrillation (Afib) has been associated with abnormal signal-averaged P wave (SAPW) parameters but whether SAPW is associated with the time course of these arrhythmias (persistent vs. paroxysmal, frequent vs. rare episodes) remains unknown. This article assesses the significance of SAPW duration in distinguishing patients with paroxysmal from those with persistent Afib. SAPW electrocardiogram was performed with a "double triggering" software system for acquisition and analysis of data. SAPW total duration (TD), X, Y, and Z leads magnitudes and vector signal magnitudes were measured offline. Optimal cutoff value between control and patient groups was determined by using a receiver operator characteristic curve. Data were analyzed to compare controls with patients groups and between patient groups according to time course of the arrhythmic history. Fifteen age-matched patients without a history of Afib and 55 patients with a history of Afib (33 with paroxysmal and 22 with persistent arrhythmia) were studied off antiarrhythmic drugs. Patients with history of persistent arrhythmia were studied within 2 days after electrical cardioversion to sinus rhythm. SAPW TD was the only parameter consistently associated with Afib. SAPW TD was 98 ± 6 ms (mean ± SD) in the control group, 127 ± 19 ms in the pooled patients group (P =.0001); 122 ± 20 ms for paroxysmal and 133 ± 17 ms for the persistent Afib group (P =.04). Analysis of other SAPW parameters were not statistically significant. SAPW duration is a simple method to identify patients with history of Afib. A significantly longer SAPW TD characterizes patients with a history of persistent as opposed to paroxysmal Afib. Prolongation of SAPW TD possibly reflects more advanced electrophysiological changes, creating a more stable substrate that leads to persistence of the arrhythmia.
KW - Atrial conduction delay
KW - Atrial fibrillation
KW - P wave
KW - Signal-averaged electrocardiogram
UR - http://www.scopus.com/inward/record.url?scp=0034947489&partnerID=8YFLogxK
U2 - 10.1054/jelc.2001.25133
DO - 10.1054/jelc.2001.25133
M3 - Article
C2 - 11455508
AN - SCOPUS:0034947489
SN - 0022-0736
VL - 34
SP - 189
EP - 195
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
IS - 3
ER -