Superiority of P-wave amplitude over P-wave duration to predict left ventricular end-diastolic pressure

2005 ◽  
Vol 38 (4) ◽  
pp. 36-37 ◽  
Author(s):  
Eunyoung Lee ◽  
Andrew D. Michaels ◽  
Dan Schindler ◽  
Barbara J. Drew
Keyword(s):  
Wave Amplitude ◽  
Diastolic Pressure ◽  
Left Ventricular ◽  
P Wave ◽  
Wave Duration ◽  
P Wave Duration

scholarly journals ECG Measurements to Emphasize Atrial Potentials Using Modified Limb Lead System

2018 ◽  
Vol 7 (3.12) ◽  
pp. 632
Author(s):  
Manikandan K ◽  
Mohanasundaram K
Keyword(s):  
Electrical Activity ◽  
Wave Amplitude ◽  
P Wave ◽  
Electrode Placement ◽  
Atrial Arrhythmias ◽  
Lead System ◽  
Wave Duration ◽  
Normal Limits ◽  
P Wave Duration ◽  
Female Subjects

With the advancement in the field of Electrocardiology (ECG), the acquisition of electrical activity of the heart plays an important role in the diagnosis of various cardiovascular diseases. In general, this activity of conduction is acquired using Standard 12 Lead ECG system. Recently, a Modified Limb Lead system has been developed to study the atrial electrical activity for the diagnosis of atrial arrhythmias. The present study is to derive the normal limits of female subjects using Modified Limb Lead (MLL) system. This study was evaluated in 59 female subjects 19.52 ± 1 (Mean ± S.D) and is primarily involved to study atrial potentials with the use of precordial and modified limb lead position. In sinus rhythm female subjects, the P wave amplitude was 33.06 ± 21.18 µV and the Ta wave amplitude was 20.72 ± 18.16 µV. The P wave duration was 94.22 ± 10.64 ms, the Ta wave duration was 85.51 ± 17.49 ms. The results show that modifications in the limb electrode placement have significant effect on amplitudes and PR segment which may be of great importance for the assessment of atrial potentials.  

scholarly journals Electrocardiographic parameters in captive, clinically healthy, Amazona ochrocephala

2015 ◽  
pp. 5037-5045
Author(s):  
Claudia Guerrero S ◽  
Janeth Bolivar B ◽  
Piero Vargas-Pinto ◽  
Pedro Vargas-Pinto ◽  
Claudia Brieva-Rico
Keyword(s):  
Heart Rate ◽  
Wave Amplitude ◽  
P Wave ◽  
S Wave ◽  
Wave Duration ◽  
T Wave ◽  
P Wave Duration ◽  
Electrocardiographic Examination ◽  
Qrs Duration ◽  
Electrocardiographic Parameters

ABSTRACT Objective. To stablish the electrocardiographic parameters of individuals of the species Amazona ochrocephala, from the Unidad de Rescate y Rehabilitacion de Animales Silvestres at the Universidad Nacional de Colombia. Materials and methods. The electrocardiographic examination was performed under inhaled anesthesia with isoflurane. Leads I, II, III, aVL, aVR and aVF were measured. Results. Electrocardiographic parameters obtained in Lead II. P wave Duration: 0.015-0.044 s, P wave amplitude: 0.031 to 0.6 mv, R wave duration: 0.015-0.022 s, amplitude R: 0.034-0.038 mv, S wave Duration: 0.019- 0.042 s, amplitude S: 0.194-0.815 mv, T wave Duration: 0.025-0.064 s, T-wave amplitude: 0.010 to 0.5 mv, PQ Duration: 0.021-0.076 s, QRS Duration: 0.036-0.068 s, QT Duration: 0.070-0.015 s, RR Duration: 0.104-0.324 s, EEM: -111° to -80°, FC: 240-600 ppm. Conclusions. The results showed different values for amplitude and duration of the P, R and T waves in comparison to those obtained in other studies. However, they were similar for heart rate, MEA and duration of the PQ/R, QT and QRS segments.

scholarly journals P-Wave Duration and Dispersion in Patients with Mitral Stenosis

2021 ◽  
Author(s):  
Wenxia Fu ◽  
Jiawei Le ◽  
Xijin Wei ◽  
lixiu chen ◽  
Wenzhao Li ◽  
...  
Keyword(s):  
Mitral Stenosis ◽  
Test Group ◽  
Wave Dispersion ◽  
Left Ventricular ◽  
P Wave ◽  
Control Group ◽  
P Wave Dispersion ◽  
Wave Duration ◽  
P Wave Duration ◽  
Increased Risk

Abstract Background: Mitral stenosis (MS) is related to prolonged inter- and intra-atrial electromechanical delays and increased P-wave dispersion. The objective of the current study was to investigate the correlation between the P-wave duration, P-wave dispersion (PWD), mitral stenosis (MS) and to explore the cut-off values for predicting the MS in the patients.Methods: We enrolled 62 patients with MS and sinus rhythm as test group, and 62 healthy subjects matched in age- and sex- were selected as control group. We conducted the 12-lead electrocardiogram and echocardiography for all the subjects. The maximum and the minimum P-wave duration and PWD were calculated. Univariate and multivariate logistic regression analyses were performed to demonstrate the correlation between P-wave duration and PWD and MS. The receiver operating characteristic (ROC) curve was drawn to detect the threshold of P-wave duration and PWD for predicting the MS.Results: There were significant differences in the left atrial diameter (45.00±5.78 vs. 32.31±4.24 cm2), pulmonary artery pressure (46.68±17.29 vs. 32.64±2.86 mm Hg), left ventricular end-diastolic diameter (47.57±4.80 vs. 45.58±5.04 cm), ejection fraction (63.10±3.05 vs. 65.13±2.56%), aortic root inside diameter (29.60±3.50 vs. 31.58±3.58) and pulmonary trunk (24.17±2.78 vs. 22.23±1.77) values between the test group and the control group. Besides, the test subjects had significantly longer maximum P-wave duration (123.42±12.33 vs. 108.18±9.07) and larger P-wave dispersion (47.24±13.61 vs. 28.94±9.19). In the multivariate analysis, maximum P-wave duration (OR:1.221, 95% CI:1.126-1.324) and P-wave dispersion (OR:1.164, 95% CI:1.094-1.238) were correlated with the occurrence of MS. The optimal threshold for the maximum P-wave duration and PWD were 119.50ms, and 42.50ms, respectively, and the areas under the curve were 0.859 and 0.865, respectively. Conclusions: A longer P-wave duration and a higher PWD are correlated with the increased risk of MS progression.

Relationship between P Wave Dispersion and Left Ventricular Diastolic Dysfunction in Hypertensive and Ischemic Heart Disease Patients

2015 ◽  
Vol 8 (1) ◽  
pp. 13-18
Author(s):  
Asif Zaman Tushar ◽  
AAS Majumder ◽  
STM Abu Azam ◽  
Mohammad Ullah ◽  
Rashid Ahmed ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Wave Dispersion ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
P Wave ◽  
P Wave Dispersion ◽  
Wave Duration ◽  
P Wave Duration ◽  
Ventricular Diastolic Dysfunction ◽  
Surface Electrocardiogram

Background: There is growing recognition that congestive heart failure caused by a predominant abnormality in left ventricular diastolic function is common and causes significant morbidity and mortality. Diastolic function usually declines before systolic function, and this precedes clinical signs. 12-lead electrocardiogram is a commonly used tool to assess left atrial enlargement, which is a marker of left ventricular diastolic dysfunction. We investigated the relationship between P wave dispersion, which is easily measured on the surface electrocardiogram and left ventricular diastolic function.Methods: There were 100 patients: 50 with diastolic dysfunction and 50 without. P wave dispersions were calculated by measuring minimum and maximum P wave duration values on the surface electrocardiogram. The relationships between P wave dispersion and echocardiographic measurements of diastolic dysfunction were assessed.Results: Maximum P wave duration was observed significantly (p=0.001) in patients with left ventricular diastolic dysfunction (119.60±8.2 ms vs 114.0±6.4 ms). Minimum P wave duration was observed significantly (p=0.001) higher in patients without diastolic dysfunction (72.6±7.5 ms vs 62.70±7.4 ms). P wave dispersion was observed significantly (p=0.001) higher in patients with left ventricular diastolic dysfunction (56.6±6.3 ms vs 41.5±5.2 ms). When patients were grouped according to grades of diastolic dysfunction, P wave dispersion was observed sequentially increased among 3 grades of left ventricular diastolic dysfunction (55.8±5.2 ms vs 55.9±7.0 ms vs 61.4±4.7) but the differences were not statistically significant (p=0.09).Conclusion: We conclude that P wave dispersion increases in diastolic dysfunction of LV. When clinical and echocardiographic variables are taken into account, there is a weak but significant correlation between P wave dispersion and left ventricular ejection fraction.Cardiovasc. j. 2015; 8(1): 13-18

P3838Evaluation of echocardiographic determinants of interatrial block in patients with essential hypertension

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Kalcik ◽  
L Bekar ◽  
O Celik ◽  
M Yetim ◽  
T Dogan ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Left Ventricular Hypertrophy ◽  
Left Ventricular Mass ◽  
Left Atrial ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
P Wave ◽  
Hypertensive Patients ◽  
Wave Duration ◽  
P Wave Duration

Abstract Introduction Interatrial block (IAB), defined as a conduction delay between the right and left atrium, is manifested on the electrocardiogram as a prolonged P-wave duration. Large number of studies recently have been published regarding the prevalence of IAB and its associations with cardiovascular events. It has been previously reported that myocardial fibrosis may cause conduction delays in hypertensive patients. In this study, we aimed to investigate the echocardiographic determinants of IAB in patients with hypertension. Methods This study enrolled a total of 220 patients [male: 93 (42.3%), mean age: 61.8±7.8 years] with hypertension. Patients with atrial fibrillation were excluded. IAB was defined as P wave duration of ≥120 ms with or without presence of notching. Routinely obtained 12-lead electrocardiography recordings were examined, and patients were divided into two groups as those with and without IAB. All patients were evaluated by transthoracic echocardiography. Results Electrocardiography revealed IAB in 70 patients. The baseline demographic characteristics of the patients with and without IAB were similar in both groups. Left atrial diameter (LAD), interventricular septal thickness, posterior wall thickness, left ventricular mass, left ventricular mass index, and the prevalence of left ventricular hypertrophy (LVH) were found to be significantly increased in hypertensive patients with IAB. Increased LAD (OR=1.082; 95% CI: 1.006–1.164; p=0.034) and LVH (OR=3.051; 95% CI: 1.164–7.994; p=0.023) were found to be independent predictors of IAB. In the receiver operating characteristic curve analyses, LAD values above 38 mm predicted IAB with a sensitivity of 68%, and a specificity of 58% (AUC= 0.678; 95% CI: 0.601–0.754; p<0.001). Conclusion A significant association exists between the presence of IAB and echocardiographic parameters related to left ventricular hypertrophy and left atrial dilatation in patients with essential hypertension. The presence of IAB may be used as an electrocardiographic marker of cardiac remodelling and myocardial fibrosis in hypertensive patients.

scholarly journals Characterization of superresponders to cryoballoon ablation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
J Marti Almor ◽  
B Casteigt ◽  
J Jimenez-Lopez ◽  
J Conejos ◽  
E Valles ◽  
...  
Keyword(s):  
Pulmonary Veins ◽  
Left Ventricular ◽  
P Wave ◽  
Left Ventricular Ejection ◽  
Cryoballoon Ablation ◽  
Ventricular Ejection Fraction ◽  
Wave Duration ◽  
P Wave Duration ◽  
Ablation Index

Abstract Background Isolation of pulmonary veins is the cornerstone in the treatment of symptomatic atrial fibrillation rather with radiofrequency or cryo balloon. Recurrence rate is quite common in the long term follow up, clearly related to previosly described factors. Nevertheless some patients maintain sinus rhythm forever after the index ablation. The aim of this study is characterize this kind of patients (so called superresponders). Methods This is a Unicentric, retrospective, consecutive study including all patients summited for cryoablation in our hospital from January 2011 to September 2020. We looked for clinical, electrical, echocardiographic variables and those linked to the ablation procedure. A transversal FU to discard recurrences was done. A univariate and multivariate logistic regression was performed. Results We included 422 patients, 193 of them were finally excluded: 21 lost in the FU, 30 got radiofrequency ablation and 142 did not reach a minimum 5 years FU. About the 229 finally included, 85 (group 1) didn't have any recurrence during the FU, in front of 144 (group2) with recurrences. The univariate analysis showed that grup 1 patients were younger, the rate of hypertension, CHA2DS2VASc score, moderate sleep apnea, body mass index (BMI), p wave duration, and the size of left atrial was lower in grup 1 in front of patients of grup 2. Left ventricular ejection fraction was higher and the number of pulmonary veins in whom the temperature was lower than −40°C in grup 1 in front to grup 2. In the multivariate analysis the p wave duration: OR 0.92; 95% CI [0.89–0.94]; p&lt;0.001, BMI kg/m2: OR 0.74; 95% CI [0.65–0.85]; p&lt;0.001, a temperature &lt;−40°C in all the targeted veins: OR 3.52 95% CI [1.45–8.54]; p=0.005 and SR on the ablation index day OR: 7.29; 95% CI [1.53–34.71]; p=0.012, maintained statistical significance. Conclusions In our series patients with a p wave duration, BMI, SR the ablation index day and achieving a temperature &lt;−40°C in all the targeted veins, resulted as protective factors to maintain SR in the long term FU. An adequate selection of patients can improve results and optimize resources. FUNDunding Acknowledgement Type of funding sources: None.

Signal-averaged P-wave Duration Does Not Predict Atrial Fibrillation after Thoracic Surgery 

1999 ◽  
Vol 91 (1) ◽  
pp. 16-23 ◽  
Author(s):  
David Amar ◽  
Nancy Roistacher ◽  
Hao Zhang ◽  
Michael S. Baum ◽  
Ilana Ginsburg ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Thoracic Surgery ◽  
Final Analysis ◽  
Left Ventricular ◽  
P Wave ◽  
Wave Duration ◽  
P Wave Duration ◽  
Patients At Risk ◽  
Echocardiographic Parameters ◽  
History Of

Background Atrial fibrillation (AF) is the most common dysrhythmia seen early after major thoracic surgery but occurs infrequently after minor thoracic or other operations. A prolonged signal-averaged P-wave duration (SAPWD) has been shown to be an independent predictor of AF after cardiac surgery. The authors sought to determine whether a prolonged SAPWD alone or in combination with clinical or echocardiographic correlates predicts AF after elective noncardiac thoracic surgery. Methods Of the 250 patients enrolled, 228 were included in the final analysis. Preoperative SAPWD was obtained in 155 patients who had major thoracic surgery and in 73 patients undergoing minor thoracic or other operations who served as comparison control subjects. The SAPWD was recorded from three orthogonal leads using a sinus P-wave template. The filtered vector composite was used to measure total P-wave duration. Clinical, surgical, and echocardiographic parameters were collected and patients followed for 30 days after surgery for the development of symptomatic AF. Results Symptomatic AF developed in 18 of 155 (12%) patients undergoing major thoracic surgery and in 1 of 73 (1%) patients having minor thoracic or abdominal surgery, most commonly 2 or 3 days after surgery. In comparison with similar patients undergoing major thoracic surgery without AF, those who developed AF were older (66+/-8 vs. 62+/-10 yr; P = 0.04) but did not differ in SAPWD (145+/-17 vs. 147+/-16, ms) in standard electrocardiographic P-wave duration (105+/-7 vs. 107+/-10 mns), incidence of left-ventricular hypertrophy on 12-lead electrocardiography, male sex, history of hypertension, diabetes, or coronary heart disease. Thoracic-surgery patients at risk for postoperative AF did not differ from all other patients at low risk for AF in clinical or SAPWD parameters. Conclusions Under the conditions of this study, SAPWD did not differentiate patients who did or did not develop AF after noncardiac thoracic surgery, and therefore its measurement cannot be recommended for the routine evaluation of these patients. Older age continues to be a risk factor for AF after thoracic surgery.

INSIGHTS ON ATRIAL ELECTROCARDIOGRAM IN SINUS RHYTHM AND ATRIOVENTRICULAR BLOCK FOR IMPROVED CLINICAL DIAGNOSIS

2021 ◽  
Author(s):  
Arya Bhardwaj ◽  
J. Sivaraman ◽  
S. Venkatesan
Keyword(s):  
Sinus Rhythm ◽  
Clinical Diagnosis ◽  
Atrioventricular Block ◽  
Wave Amplitude ◽  
Normal Sinus Rhythm ◽  
P Wave ◽  
Wave Duration ◽  
Normal Sinus ◽  
P Wave Duration ◽  
Electrocardiogram Ecg

Objective: This study aims to characterize P and Ta wave of Modified Limb Lead (MLL) Electrocardiogram (ECG) in Normal Sinus Rhythm (NSR) and Atrioventricular Block (AVB). Methods: ECGs were recorded using MLL configuration from 100 NSR volunteers (mean age 31 years, 35 women) and 20 male AVB patients (mean age 72 years). Amplitudes and durations of P, Ta wave, and PTa Interval (PTaI) were measured, plotted, and analyzed for both the groups. Results: P-wave amplitudes were larger in AVB, and also P, Ta waves correlated significantly in both groups with higher correlation in AVB (NSR: [Formula: see text]; AVB: [Formula: see text]). Ta-wave duration ([Formula: see text] ms) was longer than P-wave duration ([Formula: see text] ms) in AVB patients and was opposite to P-wave polarity in all the leads. PP Interval (PPI) correlated significantly with P wave (NSR: [Formula: see text]; AVB: [Formula: see text]), Ta wave ([Formula: see text]; [Formula: see text]), PTaI ([Formula: see text]; [Formula: see text]), and corrected PTaI ([Formula: see text]; [Formula: see text]). Conclusion: P-wave right axis shift leads to the higher P-wave amplitude in AVB which may be due to the advancing age and atrial chamber enlargement. In NSR, the duration of observable Ta wave was longer than P wave, whereas in AVB, the Ta wave duration was 3–3.5 times longer than P wave.

How to interpret the paediatric 12-lead ECG

2021 ◽  
pp. edpract-2021-322428
Author(s):  
Paraskevi Mikrou ◽  
Pushpa Shivaram ◽  
Constantinos Kanaris
Keyword(s):  
Wave Amplitude ◽  
P Wave ◽  
Reference Ranges ◽  
Qrs Complex ◽  
S Wave ◽  
Everyday Clinical Practice ◽  
Wave Duration ◽  
P Wave Duration ◽  
Qt Intervals ◽  
Core Skill

ECG interpretation is a core skill for any healthcare practitioner that looks after children. The article aims to educate the reader in basic interpretation of paediatric ECG in a succinct, interactive, organised manner in a way that it can be easily referenced and applied in everyday clinical practice. We include clinical examples as well as age and sex-related reference ranges for QT intervals, P-wave duration, Q-wave amplitude, QRS complex duration, R-wave and S-wave amplitude, R/S ratio and PR intervals.

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