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Signal‐Averaged P Wave Duration Predicts Early Recurrence of Atrial Fibrillation After Cardioversion
Author(s) -
RAITT MERRITT H.,
INGRAM KENNETH D.,
THURMAN S. MICHAEL
Publication year - 2000
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 - 10.1111/j.1540-8159.2000.tb00808.x
Subject(s) - medicine , cardioversion , cardiology , atrial fibrillation , signal averaged electrocardiogram , duration (music) , refractory period , signal averaging , electrical cardioversion , anesthesia , electrocardiography , art , literature , signal transfer function , digital signal processing , analog signal , electrical engineering , engineering
Thirty‐two patients had signal‐averaged P wave duration measured after electrical cardioversion of AF, and were followed for 1 year or until there was a recurrence. The use of antiarrhyth‐mic medications was left to the discretion of the attending physician. Among 20 patients not taking an‐tiarrhythmic medication, the 11 patients who had a recurrence of AF within 3 months of cardioversion had a significantly longer signal‐averaged P wave duration compared to the 9 patients who did not (148 ± 17 vs 135 ± 20 ms, P = 0.005). There was no difference, in clinical parameters or left atrial diameter. A signal‐averaged P wave duration cutoff anywhere between 130 and 135 ms correctly classified 85% of patients with a sensitivity of 81 % and a specificity of 89%, In patients taking antiarrhythmic medications, signal‐averaged P wave duration did not correlate with the risk of recurrence. In patients not taking antiarrhythmic medications, signal‐averaged P wave duration can be used to predict the risk of an early recurrence of AF after cardioversion. The poor predictive value in patients taking antiarrhythmics may be due to changes in the atrial refractory period, which are not reflected in P wave duration.