Detection of inter-atrial conduction defects with unfiltered signal-averaged P-wave ECG in patients with lone atrial fibrillation

Pyotr Platonov, Jonas Carlson, Max Ingemansson, Anders Roijer, A Hansson, L V Chireikin, Bertil Olsson

Research output: Contribution to journalArticlepeer-review

80 Citations (SciVal)

Abstract

AIMS: To demonstrate a possible inter-atrial conduction delay in patients with lone paroxysmal atrial fibrillation (PAF) using 'unfiltered' signal-averaged P-wave ECG (PSAECG) and compare these results with those obtained with conventional filter settings. METHODS AND RESULTS: Twenty one patients with lone PAF and 20 healthy volunteers (control group) were enrolled in the study. An orthogonal lead surface ECG was high-pass filtered at 0.8 Hz, averaged with template matching, and combined into a spatial magnitude ('unfiltered' technique). Results were compared with conventionally filtered (40-300 Hz) PSAECG. The filtered technique revealed no differences in P-wave duration between the two groups (121 +/- 12 vs 128 +/- 15 ms, control and PAF groups respectively, ns). Double-peaked P-wave spatial magnitudes (interpeak distance >30 ms) were revealed in 11 of 21 PAF patients but only in two of 18 controls (P<0.01). The nadir in the spatial magnitude was located significantly later in the PAF group (114 +/- 13 vs 103 +/- 9 ms, P<0.01). CONCLUSION: 'Unfiltered' PSAECG revealed significant differences in orthogonal P-wave morphology in patients with lone PAF, indicating the possibility of an inter-atrial conduction delay, while conventional P-wave duration analysis failed to discriminate between the two groups.
Original languageEnglish
Pages (from-to)32-41
JournalEuropace
Volume2
Issue number1
DOIs
Publication statusPublished - 2000

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems

Keywords

  • Signal-averaged P-wave ECG
  • paroxysmal atrial fibrillation
  • inter-atrial conduction

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