[High-resolution P-wave electrocardiogram in patients with a history of paroxysmal atrial fibrillation].

PURPOSE: To study by using the signal-averaged P wave, the atrial activation of patients with documented episodes of paroxysmal atrial fibrillation (PAF).

METHODS

This study enrolled a total of 20 patients with documented episodes of paroxysmal atrial fibrillation (males 14; mean age 58.4 +/- 10.6 years). The signal-averaged P wave was recorded with a Corazonix Predictor II system. The total P wave duration was determined from the combined filtered x,y,z vector-magnitude and used for analysis. The results were compared with a normal group of 10 patients, matched in age.

RESULTS

In the control group, the total P wave duration ranged from 120.0 to 135.0 (mean = 128.3 +/- 5.8) ms. In the group of PAF, the total P wave duration ranged from 118.0 to 168.5 (mean = 151.5 +/- 13.7) ms (p < 0.000). Sixteen (80%) of this patients showed a P wave duration > 140.0 ms. With a cut < 140.0 ms for the normal atrial activation, the sensitivity was 76%, specificity was 100%, positive and negative predictive value were 100% and 60% respectively for the method detected patients with PAF.

CONCLUSION

Patients with PAF showed a prolonged signal-averaged P wave duration and should be differentiated by this method from the normal population.