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P Wave Signal‐Averaged Electrocardiography to Identify Risk for Atrial Fibrillation
Author(s) -
DARBAR DAWOOD,
JAHANGIR ARSHAD,
HAMMILL STEPHEN C.,
GERSH BERNARD J.
Publication year - 2002
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2002.01447.x
Subject(s) - medicine , signal averaged electrocardiogram , qrs complex , cardiology , atrial fibrillation , electrocardiography , signal averaging , signal transfer function , digital signal processing , analog signal , electrical engineering , engineering
DARBAR, D., et al. : P Wave Signal‐Averaged Electrocardiography to Identify Risk for Atrial Fibrillation. AF is the most common sustained cardiac arrhythmia, and this prevalence is increasing. The impact of AF on morbidity and mortality is substantial, as are the socioeconomic consequences like higher health care costs, chronic disease management, and disabilities. Early recognition of patients at high risk for AF, combined with effective management, may help prevent AF from becoming chronic, helping to minimize potential health risks, costs, and other complications. P wave signal‐averaged electrocardiography (SAECG) has been shown to have a potential role in identifying patients at risk of developing paroxysmal AF and those likely to change from paroxysmal AF to chronic AF. The theoretical rationale of P wave SAECG in patients with AF is delay in the intraatrial and interatrial conduction. Intraatrial conduction delays can be seen on the surface electrocardiogram as P wave prolongation, which is more visible with averaging techniques and high resolution recording devices. Averaging followed by amplification after proper filtering of the electrical signal allows more precise measurements of duration and amplitude of the P wave. Data on reproducibility, filter settings, number of beats to be averaged, and definitions of the onset and offset depend on the system used, which can be QRS or, preferably, P wave triggered. A prolonged P wave duration is one of the best predictors of perioperative AF, but the role of P wave SAECG in the paroxysmal form is less well defined. Combining P wave duration with other predictors for AF improves the diagnostic value of P wave SAECG.