Signal-averaged P wave in patients with wolff-parkinson-white syndrome after successful radiofrequency catheter ablation

Abstract

In the current study, the signal-averaged P wave showed a prolonged intraatrial conduction time in patients with the Wolff-Parkinson-White syndrome and paroxysmal atrial fibrillation. These patients can be differentiated from those with the pre-excitation syndrome without clinical atrial fibrillation as well as from normal subjects. The prolonged intraatrial conduction time may serve as an atrial substratum for development and maintenance of the fibrillatory state.

Increased P wave dispersion after the radiofrequency catheter ablation in overt pre-excitation patients: the role of atrial vulnerability

“…In this study, we have found that the patients with previous PAF attacks had greater P max values indicating prolonged intra-atrial conduction time and PWD values reflecting more inhomogeneous, nonuniform atrial conduction, after RF catheter ablation. Similar findings have been noted by Maia et al [25] and they concluded that the prolonged intra-atrial conduction time may serve as an atrial substratum for development and maintenance of the fibrillatory state using signal-averaged P wave analysis. Therefore, we concluded that not only the accessory pathway but also inhomogenous propagation of sinus impulses may play an important role in occurrence of AF in patients with pre-excitation.…”

Age‐Related Changes in Human Left and Right Atrial Conduction

“…All of our patients were free of AF during the procedure despite programmed stimulation and during clinical follow‐up. It is possible that the atrial electrophysiology of patients with accessory pathways may not reflect the normal aging process but access to the left atrial would not have been ethically possible in a truly normal cohort, and although there have been no invasive studies comparing parameters of conduction between WPW patients without AF and age‐matched normal subjects, P wave durations of the signal‐averaged ECG have been shown to be similar in these two groups; although for reasons discussed above, P wave duration is at best a surrogate marker for interatrial conduction 34 …”

Role of invasive and noninvasive testing in risk stratification of sudden cardiac death in children and young adults: an electrophysiologic perspective

“…Although signal-averaged P wave ECG of greater than 130 milliseconds has no use in predicting sudden death, it was shown to predict recurrence of atrial fibrillation after ablation of accessory pathway in a cross-sectional study and a prospective study [64,65].…”