Circulation, Vol 83, 162-169, Copyright © 1991 by American Heart Association
M Fukunami, T Yamada, M Ohmori, K Kumagai, K Umemoto, A Sakai, N Kondoh, T Minamino and N Hoki
To determine whether patients at risk for paroxysmal atrial fibrillation
could be detected while in sinus rhythm, the signal- averaged
electrocardiogram triggered by P waves was recorded in 42 patients with
paroxysmal atrial fibrillation (Paf group) and in 50 control patients. The
root mean square voltages (LP10, LP20, and LP30) for the last 10, 20, and
30 msec and the duration (Ad) of filtered (40- 300 Hz) P wave of the
spatial magnitude were measured. LP10 and LP20 were significantly lower in
the Paf than in the control group (LP10, 1.92 +/- 0.58 versus 2.49 +/- 0.78
microV, p less than 0.001; LP20, 2.47 +/- 0.78 versus 3.46 +/- 1.20 microV,
p less than 0.0001), although no significant difference in LP30 was found
between groups. Ad was also significantly longer in the Paf than in the
control group (137.0 +/- 14.3 versus 118.6 +/- 11.3 msec, p less than
0.001). These differences between the Paf and control groups remained
significant even after dividing by the presence or absence of organic heart
diseases. The criteria of "LP20 = 3.5 microV or less" and "Ad greater than
120 msec" as defining "atrial late potential" gave a sensitivity of 91% and
a specificity of 76%. These findings suggest that patients at risk for
paroxysmal atrial fibrillation could be detected while in sinus rhythm by
using the P wave-triggered signal-averaged electrocardiogram.
ARTICLES
Detection of patients at risk for paroxysmal atrial fibrillation during sinus rhythm by P wave-triggered signal-averaged electrocardiogram
Division of Cardiology, Osaka Prefectural Hospital, Japan.
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