Related Experiment Video

Updated: Oct 29, 2025

High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation
09:17

High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation

Published on: July 29, 2011

15.0K

Abnormal P-wave terminal force in lead V1 is associated with low left atrial appendage ejection velocity

Nathaniel McConkey1, Peter Malamas1, Faye L Norby1

  • 1The Electrophysiology Program, Penn State Heart and Vascular Institute, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.

Journal of Electrocardiology
|July 9, 2021
PubMed

Insights

Abnormal P-wave terminal force in V1 is linked to reduced left atrial appendage ejection velocity in patients with atrial fibrillation. This finding may help predict stroke risk in AF patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Imaging

Background:

  • Atrial fibrillation (AF) increases stroke risk, primarily via left atrial appendage (LAA) thromboembolism.
  • Left atrial (LA) and LAA dysfunction are implicated in AF-related stroke.
  • Sinus P-wave abnormalities are associated with stroke in AF patients.

Purpose of the Study:

  • To investigate the association between abnormal P-wave terminal force in V1 (aPTFV1) and decreased LAA ejection velocity (LAAV).
  • To assess if aPTFV1 can serve as a predictor of LAA dysfunction in patients with AF.

Main Methods:

  • Retrospective cross-sectional study of 169 patients undergoing transesophageal echocardiography (TEE) in sinus rhythm.
  • Exclusion criteria included congenital heart disease, age <18, cardiac transplant, and chronic atrial pacing.
  • Logistic regression analysis was used to determine the odds of low LAAV (<40 cm/s) associated with aPTFV1.

Main Results:

  • The multivariate odds ratio of aPTFV1 for LAAV <40 cm/s was 2.24 (95% CI: 1.13-6.00), after adjusting for CHA₂DS₂-VASc variables, heart rate, atrial arrhythmia history, and LA volume index.
  • 28% of the study cohort exhibited LAAV <40 cm/s.

Conclusions:

  • Abnormal P-wave terminal force in lead V1 is significantly associated with low LAA ejection velocity.
  • These findings suggest aPTFV1 may be a useful non-invasive marker for LAA dysfunction in AF patients.
  • Further research is warranted to validate these findings and determine clinical utility for stroke risk stratification.
Abstract

Keywords:
Atrial cardiomyopathyAtrial fibrillationLeft atrial appendageP wave terminal forceStrokeTransesophageal echocardiogram

More Related Videos

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

10.6K
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

33.6K

Related Concept Videos

Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
1.7K
Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
257
Dysrhythmias III: Characteristics of Dysrhythmias01:29

Dysrhythmias III: Characteristics of Dysrhythmias

Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per...
204
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
220
Cardiovascular System Abnormal Findings I: Inspection and Palpation01:29

Cardiovascular System Abnormal Findings I: Inspection and Palpation

In a cardiovascular examination, inspection and palpation are crucial for identifying abnormalities.
Abnormal findings observed during an inspection
603
Cardiovascular System Abnormal Findings II: Auscultation01:25

Cardiovascular System Abnormal Findings II: Auscultation

Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
Abnormal Heart Sounds
Gallops:
323