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

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T1 - Physiological variation in left atrial transverse orientation does not influence orthogonal P-wave morphology

AU - Petersson, Richard

AU - Mosén, Henrik

AU - Steding-Ehrenborg, Katarina

AU - Carlson, Jonas

AU - Faxén, Lisa

AU - Mohtadi, Alan

AU - Platonov, Pyotr G.

AU - Holmqvist, Fredrik

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Atrial electrophysiology

KW - Atrial orientation

KW - Atrium

KW - Echocardiography

KW - Electrocardiography

KW - P-wave morphology

UR - http://www.scopus.com/inward/record.url?scp=84981747113&partnerID=8YFLogxK

U2 - 10.1111/anec.12392

DO - 10.1111/anec.12392

M3 - Article

VL - 22

JO - Annals of Noninvasive Electrocardiology

JF - Annals of Noninvasive Electrocardiology

SN - 1082-720X

IS - 2

M1 - e12392

ER -