Physiological variation in left atrial transverse orientation does not influence orthogonal P-wave morphology

Richard Petersson, Henrik Mosén, Katarina Steding-Ehrenborg, Jonas Carlson, Lisa Faxén, Alan Mohtadi, Pyotr G. Platonov, Fredrik Holmqvist

Research output: Contribution to journalArticlepeer-review

Abstract

Background: It has previously been demonstrated that orthogonal P-wave morphology in healthy athletes does not depend on atrial size, but the possible impact of left atrial orientation on P-wave morphology remains unknown. In this study, we investigated if left atrial transverse orientation affects P-wave morphology in different populations. Methods: Forty-seven patients with atrial fibrillation, 21 patients with arrhythmogenic right ventricular cardiomyopathy, 67 healthy athletes, and 56 healthy volunteers were included. All underwent cardiac magnetic resonance imaging or computed tomography and the orientation of the left atrium was determined. All had 12-lead electrocardiographic recordings, which were transformed into orthogonal leads and orthogonal P-wave morphology was obtained. Results: The median left atrial transverse orientation was 87 (83, 91) degrees (lower and upper quartiles) in the total study population. There was no difference in left atrial transverse orientation between individuals with different orthogonal P-wave morphologies. Conclusions: The physiological variation in left atrial orientation was small within as well as between the different populations. There was no difference in left atrial transverse orientation between subjects with type 1 and type 2 P-wave morphology, implying that in this setting the P-wave morphology was more dependent on atrial conduction than orientation.

Original languageEnglish
Article numbere12392
JournalAnnals of Noninvasive Electrocardiology
Volume22
Issue number2
Early online date2016 Aug 17
DOIs
Publication statusPublished - 2017

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems

Free keywords

  • Atrial electrophysiology
  • Atrial orientation
  • Atrium
  • Echocardiography
  • Electrocardiography
  • P-wave morphology

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