Mark Potse1, Theo A R Lankveld2, Stef Zeemering3, Pieter C Dagnelie4, Coen D A Stehouwer5, Ronald M Henry5, André C Linnenbank6, Nico H L Kuijpers7, Ulrich Schotten3. 1. Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands. Electronic address: mark@potse.nl. 2. Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands. 3. Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands. 4. Department of Epidemiology, Maastricht University; CARIM School for Cardiovascular Diseases, Maastricht University; CAPHRI School for Public Health and Primary Care, Maastricht University. 5. CARIM School for Cardiovascular Diseases, Maastricht University; Department of Internal Medicine, Maastricht University Medical Centre. 6. Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 7. Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands.
Abstract
BACKGROUND: P waves reported in electrocardiology literature uniformly appear smooth. Computer simulation and signal analysis studies have shown much more complex shapes. OBJECTIVE: We systematically investigated P-wave complexity in normal volunteers using high-fidelity electrocardiographic techniques without filtering. METHODS: We recorded 5-min multichannel ECGs in 16 healthy volunteers. Noise and interference were reduced by averaging over 300 beats per recording. In addition, normal P waves were simulated with a realistic model of the human atria. RESULTS: Measured P waves had an average of 4.1 peaks (range 1-10) that were reproducible between recordings. Simulated P waves demonstrated similar complexity, which was related to structural discontinuities in the computer model of the atria. CONCLUSION: The true shape of the P wave is very irregular and is best seen in ECGs averaged over many beats.
BACKGROUND: P waves reported in electrocardiology literature uniformly appear smooth. Computer simulation and signal analysis studies have shown much more complex shapes. OBJECTIVE: We systematically investigated P-wave complexity in normal volunteers using high-fidelity electrocardiographic techniques without filtering. METHODS: We recorded 5-min multichannel ECGs in 16 healthy volunteers. Noise and interference were reduced by averaging over 300 beats per recording. In addition, normal P waves were simulated with a realistic model of the human atria. RESULTS: Measured P waves had an average of 4.1 peaks (range 1-10) that were reproducible between recordings. Simulated P waves demonstrated similar complexity, which was related to structural discontinuities in the computer model of the atria. CONCLUSION: The true shape of the P wave is very irregular and is best seen in ECGs averaged over many beats.
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