[High resolution electrocardiography of P-wave signals in clinical cardiology]

Signal-averaged electrocardiography of the QRS complex detects presence of late potentials which represent significant arrhythmogenic marker responsible for increased risk of life-threatening ventricular arrhythmias especially in post myocardial infarction patients. The P wave signal-averaged electrocardiography has been designed to predict development of atrial fibrillation in different populations of patients. Many P wave signal-averaging methodological procedures have been developed. However their common disadvantages remain lack of standardization, relatively low specificity and sensitivity, low positive predictive value as well as limited number of larger prospective clinical trials. Recent software and technological improvements of the P wave high resolution techniques as well as some new reports about the influence of antiarrhythmic drugs on the parameters of the P wave signal-averaged electrocardiography are creating new possibilities not only for the diagnosis of paroxysmal atrial fibrillation but also for the prediction of antiarrhythmic drug efficiency.