P Wave Signal-Averaged ECG in Normal Population and in Patients with Converted Atrial Fibrillation

Militaru, Constantin; Donoiu, I; Ionescu, DD

doi:10.1111/j.1542-474x.2011.00462.x

Cited by 7 publications

(11 citation statements)

References 9 publications

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“…In the largest one, Dhala et al established standard SAPW parameters in healthy subjects according to age and sex using the Phi‐Res Marquette system and found that FPD was sex‐dependent and longer in men, but not related to age. In this study, as in others, a weak but significant correlation with age was observed. In Dhala's study, FPD was shorter in healthy patients compared to patients with a history of paroxysmal AF and these observations have been confirmed by others …”

Section: Discussionsupporting

confidence: 83%

“…In the literature, several studies have been published on that subject. Results have been conflicting because these studies had different designs, different methodologies, different patient populations, and different endpoints.…”

Section: Discussionmentioning

confidence: 99%

“…Results have been conflicting because these studies had different designs, different methodologies, different patient populations, and different endpoints. Some studies have concluded that FPD was able to identify patients prone to AF recurrences after electrical cardioversion whereas others showed that FPD was not useful to assess the risk of AF recurrence . Chalfoun et al studied the reverse electrical remodeling after ECV using the SAPW.…”

Section: Discussionmentioning

confidence: 99%

“…The signal‐averaged electrocardiogram (SAECG) is a simple noninvasive tool, which has been used for years, initially to evaluate the presence of ventricular late potentials, and the technology has been extended to analyse the P wave in order to provide a more accurate evaluation of atrial conduction. Several studies have used this method and the related P‐wave parameters to predict AF recurrences after electrical cardioversion but results have been controversial essentially because the design of the published trials and the SAECG systems used have been different . In this study, we hypothesized that the signal‐averaged P‐wave (SAPW) ECG could be a useful, inexpensive and simple predictive marker of AF recurrences in an unselected “real‐world” patients population submitted to direct current electrical cardioversion.…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of P‐Wave Signal Averaging to Predict Atrial Fibrillation Recurrences after Electrical Cardioversion

Blanche

Tran

Carballo

et al. 2014

Noninvasive Electrocardiol

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Background: Accurate markers of atrial fibrillation (AF) recurrences after electrical cardioversion (ECV) are lacking. This study was conducted to assess the value of P-wave signal averaging (SAPW) for predicting AF recurrences in a nonselected patients population submitted to ECV.Methods: A total of 133 patients (107 males, 26 females, mean age 66 ± 9 years) were included after successful ECV for persistent AF (mean duration of AF 3.6 ± 2.2 months). The mean ejection fraction (EF) was 60 ± 9%, and left atrial (LA) diameter was 44 ± 6 mm. SAPW ECG was obtained immediately after ECV and patients were prospectively followed.Results: During a mean follow-up of 8.9 ± 5.2 months, AF recurrences occurred in 40.6% (54/133). No SAPW parameters was statistically different between the group of patients with and the group without recurrences. Recurrences were less often observed in patients with a total P-wave duration <150 ms (16/52 or 31% vs 38/81 or 47% in patients with total P-wave duration ≥150 ms) but the difference was not statistically different (P = 0.07). P-wave duration was correlated with age (r = 0.32; P < 0.001) and left atrial diameter (r = 0.19; P = 0.02). Age, sex, structural heart disease, amiodarone therapy, or hypertension were not associated with AF recurrences but patients without recurrences had a shorter AF duration (P = 0.001) and more often had a history of previous ablation (P = 0.027).Conclusion: In this unselected "real-life" group of patients submitted to ECV for persistent AF, none of the SAPW parameters, including total filtered P-wave duration, was able to predict AF recurrences.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Usefulness of P‐Wave Signal Averaging to Predict Atrial Fibrillation Recurrences after Electrical Cardioversion

Blanche

Tran

Carballo

et al. 2014

Noninvasive Electrocardiol

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“…Several studies showed that P wave SAECG analysis and the identification of ALP could be used in exposing those patients at risk for atrial fibrillation [3,4,[10][11][12][13]. We aimed to evaluate the role of ALP and P wave SAECG parameters as tools for risk stratification for developing supraventricular arrhythmias in COPD patients.…”

Section: Discussionmentioning

confidence: 99%

P Wave Signal-Averaged Electrocardiography in Patients with Chronic Obstructive Pulmonary Disease

Buzea

Dan

Delcea

et al. 2015

Romanian Journal of Internal Medicine

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The impact of left atrial pressure on filtered P-wave duration in patients with atrial fibrillation

et al. 2016

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The cause of prolonged filtered P-wave duration (FPD) remains unclear in atrial fibrillation (AF) patients with normal left atrial size. We investigated whether FPD is associated with left atrial pressure (LAP) in AF patients without prominent LA enlargement. This study included 80 patients (48 men, age 65 ± 9 years, 25 persistent AF) with non-valvular AF who underwent catheter ablation (CA) for AF. LAP was measured in sinus rhythm during CA and signal-averaged electrocardiogram was recorded after CA. We retrospectively assessed the clinical and echocardiographic variables. Prolonged FPD was defined as FPD > 120 ms. Prolonged FPD (FPD > 120 ms) was detected in 23/80 patients (29 %). According to univariate analysis, higher mean LAP (14.9 ± 4.4 vs. 10.8 ± 3.5 mmHg, p < 0.0001), higher prevalence of persistent arrhythmia, higher BNP, larger LAD, higher E wave, and lower LVEF were associated with Prolonged FPD. According to multivariate analysis, higher mean LAP was the only factor associated with Prolonged FPD (p = 0.0058, OR 1.256 for each 1 mmHg increase in mean LAP, 95 % CI 1.068-1.476). Moreover, a significant correlation was observed between FPD and mean LAP (r = 0.503, p < 0.0001). Prolonged FPD is associated with high LAP in AF patients without prominent left atrial enlargement. Pressure overload of the left atria might cause slowing of atrial electrical activation.

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P Wave Signal-Averaged ECG in Normal Population and in Patients with Converted Atrial Fibrillation

Abstract: Filtered P wave duration was higher in men; PWD was weakly but significantly correlated with age. Patients with paroxysmal or persistent AF converted to sinus rhythm had significantly higher P wave duration and P wave integral.

Cited by 7 publications

References 9 publications

Usefulness of P‐Wave Signal Averaging to Predict Atrial Fibrillation Recurrences after Electrical Cardioversion

Usefulness of P‐Wave Signal Averaging to Predict Atrial Fibrillation Recurrences after Electrical Cardioversion

P Wave Signal-Averaged Electrocardiography in Patients with Chronic Obstructive Pulmonary Disease

The impact of left atrial pressure on filtered P-wave duration in patients with atrial fibrillation

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