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Signal-averaged electrocardiograms in patients with atrial fibrillation or flutter
T R Engel1, N Vallone, J Windle
1Department of Internal Medicine, University of Nebraska College of Medicine, Omaha.
American Heart Journal
|March 1, 1988
Summary
Signal-averaged P waves, specifically high-frequency, high-amplitude P (HiFP) potentials, do not reliably predict atrial fibrillation or flutter (AFF). This study found no significant differences in HiFP duration or related measures between normal subjects, control patients, and those with AFF.
Area of Science:
- Electrophysiology
- Cardiology
- Signal Processing
Background:
- Prolonged signal-averaged QRS complexes with low-amplitude late potentials are known predictors of ventricular tachycardia.
- The potential for similar atrial signals to predict atrial arrhythmias like atrial fibrillation or flutter (AFF) was unexplored.
Purpose of the Study:
- To investigate whether signal-averaged low-amplitude atrial potentials can predict the occurrence of atrial fibrillation or flutter (AFF).
Main Methods:
- Defined low-amplitude potentials as high-frequency, high-amplitude P (HiFP) duration (50–250 Hz, 1.0 mm/microV) minus unfiltered P (UnFP) duration (0.1 mm/microV).
- Measured HiFP duration, HiFP-UnFP interval, and the duration of signals < 10 microV in normal subjects, control patients, and patients with paroxysmal or recently cardioverted AFF.
Main Results:
- HiFP duration was significantly wider in control patients compared to normal subjects (133.5 msec vs. 115.6 msec, p < 0.005).
- However, the HiFP-UnFP interval and the duration of signals < 10 microV were similar between normal subjects and control patients.
- Patients with AFF did not exhibit significantly longer HiFP or HiFP-UnFP intervals compared to control patients.
Conclusions:
- Signal-averaged P wave analysis, as defined in this study, does not appear to be a reliable method for identifying patients at risk for or experiencing atrial fibrillation or flutter.
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