BACKGROUND: Orthogonal P-wave morphology in healthy men and women has been described using unfiltered signal-averaged technique and holds information on interatrial conduction. The stability of P-wave morphology in healthy subjects over time is not fully known. METHODS: Sixty-seven healthy volunteers were investigated (29 males, aged 63 +/- 14 years, 48 females, 60 +/- 13 years). Orthogonal lead data (X, Y, and Z) were derived from standard 12-lead ECGs (recording length 6 minutes, sampling rate 1kHz, resolution 0.625 muV) recorded at baseline (BL), and 3 years later at follow-up (FU). P waves were then signal-averaged and analyzed regarding P-wave morphology, locations of maxima, minima, zero-crossings, and P-wave duration (PWD). RESULTS: No differences of P-wave variables were observed at FU compared to BL, including PWD (127 +/- 12 vs 125 +/- 14 ms at BL and FU, respectively, n.s.). In 59 of the 67 subjects (88%), the P-wave morphology was unaltered at FU. However, in the remaining eight cases a distinctively different morphology was observed. The most common change (P=0.030) was from negative polarity to biphasic (-/+) in Lead Z (n=5). In one case the opposite change was observed and in two cases transition into advanced interatrial block morphology was evident at FU. CONCLUSIONS: In the majority of healthy subjects, P-wave morphology is stable at 3-year FU. Subtle morphological changes, observed principally in Lead Z, suggest variation of interatrial conduction. These changes could not be detected by measuring conventional PWD that remained unchanged in the total population.
BACKGROUND: Orthogonal P-wave morphology in healthy men and women has been described using unfiltered signal-averaged technique and holds information on interatrial conduction. The stability of P-wave morphology in healthy subjects over time is not fully known. METHODS: Sixty-seven healthy volunteers were investigated (29 males, aged 63 +/- 14 years, 48 females, 60 +/- 13 years). Orthogonal lead data (X, Y, and Z) were derived from standard 12-lead ECGs (recording length 6 minutes, sampling rate 1kHz, resolution 0.625 muV) recorded at baseline (BL), and 3 years later at follow-up (FU). P waves were then signal-averaged and analyzed regarding P-wave morphology, locations of maxima, minima, zero-crossings, and P-wave duration (PWD). RESULTS: No differences of P-wave variables were observed at FU compared to BL, including PWD (127 +/- 12 vs 125 +/- 14 ms at BL and FU, respectively, n.s.). In 59 of the 67 subjects (88%), the P-wave morphology was unaltered at FU. However, in the remaining eight cases a distinctively different morphology was observed. The most common change (P=0.030) was from negative polarity to biphasic (-/+) in Lead Z (n=5). In one case the opposite change was observed and in two cases transition into advanced interatrial block morphology was evident at FU. CONCLUSIONS: In the majority of healthy subjects, P-wave morphology is stable at 3-year FU. Subtle morphological changes, observed principally in Lead Z, suggest variation of interatrial conduction. These changes could not be detected by measuring conventional PWD that remained unchanged in the total population.
Authors: Elias Gialafos; Theodora Psaltopoulou; Theodore G Papaioannou; Andreas Synetos; Polychronis Dilaveris; George Andrikopoulos; Konstantinos Vlasis; John Gialafos; Christodoulos Stefanadis Journal: Am J Cardiol Date: 2007-07-05 Impact factor: 2.778
Authors: F X Roithinger; J Cheng; A SippensGroenewegen; R J Lee; L A Saxon; M M Scheinman; M D Lesh Journal: Circulation Date: 1999-10-26 Impact factor: 29.690
Authors: Antonio De Sisti; Jean François Leclercq; Marcel Stiubei; Pierre Fiorello; Franck Halimi; Patrick Attuel Journal: Pacing Clin Electrophysiol Date: 2002-11 Impact factor: 1.976