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

Buzea, A.; Dan, A.; Delcea, Caterina; Balea, Marius Ioan; Gologanu, Daniela; Dobranici, Mihaela; Popescu, Raluca; Dan, Gheorghe Andrei

doi:10.1515/rjim-2015-0040

Cited by 2 publications

(4 citation statements)

References 15 publications

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“…P-wave duration and PQ interval were also reported to be risk factors for AF development in patients with P pulmonale, and P-wave duration is highly correlated with PQ interval >150 ms [31]. On the contrary, Buzea et al reported that in patients with acute COPD exacerbations, P-wave signal averaged electrocardiography (SAECG) analysis and atrial late potentials detection seem to have little value in the arrhythmic risk evaluation [32].…”

Section: Pathophysiological Mechanisms Implicating Chronic Obstructive Pulmonary Disease In Atrial Fibrillationmentioning

confidence: 99%

Chronic obstructive pulmonary disease and atrial fibrillation: An unknown relationship

Goudis

2017

Journal of Cardiology

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Chronic obstructive pulmonary disease (COPD) is independently associated with atrial fibrillation (AF). Decreased oxygenation, hypercapnia, pulmonary hypertension, diastolic dysfunction, oxidative stress, inflammation, changes in atrial size by altered respiratory physiology, increased arrhythmogenicity from nonpulmonary vein foci commonly located in the right atrium, and respiratory drugs have been implicated in the pathogenesis of AF in COPD. The understanding of the relationship between COPD and AF is of particular importance, as the presence of the arrhythmia has significant impact on mortality, especially in COPD exacerbations. On the other hand, COPD in AF is associated with AF progression, success of cardioversion, recurrence of AF after catheter ablation, and increased cardiovascular and allcause mortality. Treatment of the underlying pulmonary disease and correction of hypoxia and acid-base imbalance represents first-line therapy for COPD patients who develop AF. Cardioselective b-blockers are safe and can be routinely used in COPD. In addition, AF ablation was proved to be efficient and safe, and improves quality of life in these patients. This review presents the association between COPD and AF, describes the pathophysiological mechanisms implicated in AF development in COPD, underlines the prognostic significance of AF in COPD patients and vice versa, and highlights emerging therapeutic approaches in this setting.

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Section: Pathophysiological Mechanisms Implicating Chronic Obstructive Pulmonary Disease In Atrial Fibrillationmentioning

confidence: 99%

Chronic obstructive pulmonary disease and atrial fibrillation: An unknown relationship

Goudis

2017

Journal of Cardiology

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“…P-wave signal-averaged electrocardiography, atrial late potentials (ALP), and abnormal intra-P-wave potentials could detect patients at risk of supraventricular arrhythmias, especially atrial ibrillation [42,43]. ALP originates from areas of delayed and heterogenous conduction within the atrial myocardium, responsible for the occurrence of AF [44].…”

Section: P-wave Potentialsmentioning

confidence: 99%

“…There is no consensus about the cut-of point for FPD, which was 121 ms in hypertensive patients Auriti et al [48], 124 ms in patients in sinus rhythm, 136 ms in hypertensive patients with a history of atrial ibrillation, 132 ms in patients with COPD, and 155 ms in several other studies [43,45,46,49], diferences related to diferent averaging and iltering methods [45].…”

Section: P-wave Potentialsmentioning

confidence: 99%

“…P-wave SAECG analysis has litle value in the arrhythmic risk evaluation of these patients Isolated atrial premature beats (APB) and supraventricular tachycardia (SVT) Buzea et al [43] 37 hypertensive patients with a irst AF episode 37 age-and sex-matched hypertensive controls without AF P-wave temporal and energy characteristics can identify hypertensive patients at risk of AF recurrence Dakos et al [50] 68 stroke patients in sinus rhythm, without history of AF ALP is a novel predictor of AF in stroke patients. P-SAECG should be considered in stroke Fragmentations are expected to occur throughout atrial depolarization and not only in its terminal part, and inter-and intra-atrial conduction may be impaired [42].…”

Section: Follow Up Referencesmentioning

confidence: 99%

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Signal-Averaged ECG: Basics to Current Issues

Mozoş¹,

Stoian²

2017

Interpreting Cardiac Electrograms - From Skin to Endocardium

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Signal-averaged ECG (SAECG) is a high-resolution, noninvasive electrocardiographic method enabling detection of late ventricular potentials (LVP), which are low-amplitude and high-frequency signals, predicting reentry ventricular arrhythmias, and sudden cardiac death (SCD). Three criteria are used to detect late ventricular potentials as follows: signal-average ECG QRS duration (SAECG-QRS), the duration of the terminal part of the QRS complex with an amplitude below 40 μV (LAS40) and the root mean square (RSM) signal amplitude of the last 40 ms of the signal < 20 μV (RMS40). Late ventricular potentials can be detected not only at the end of a QRS complex but also as intra-QRS (IQRS) potentials. Signal-averaged ECG was modiied to enable the analysis of the P-wave and to detect atrial late potentials (ALPs), low-amplitude potentials at the terminal part of the iltered P-wave, and predictors of atrial ibrillation (AF). Late atrial and ventricular potentials originate from areas of delayed, fragmented, and heterogenous conduction within atrial or ventricular myocardium. This chapter reviews the most important mechanisms explaining the occurrence of late ventricular, intra-QRS, and atrial potentials; their predictive value for arrhythmia, focusing on recent clinical data, long-term follow-up, and outcome; and analysis of SAECG variables in cardiac and noncardiac diseases.

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

Abstract: The patients with acute exacerbation of COPD but no apparent cardiac disease have a higher incidence of supraventricular arrhythmias. P-wave SAECG analysis and ALP detection have little value in the arrhythmic risk evaluation of these patients.

Cited by 2 publications

References 15 publications

Chronic obstructive pulmonary disease and atrial fibrillation: An unknown relationship

Chronic obstructive pulmonary disease and atrial fibrillation: An unknown relationship

Signal-Averaged ECG: Basics to Current Issues

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