SIGNAL-AVERAGED P-WAVE - PREDICTOR OF ATRIAL-FIBRILLATION

P Wave Averaging and AF. Abnormalities of the P wave seen during sinus rhythm are associated with atrial fibrillation and other supraventric ular arrhythmias. Intra-atrial conduction delays can be seen on the su rface ECG as P wave prolongation, which is more visible with averaging techniques used in advanced recording devices, Averaging followed by amplification after proper filtering of the electrical signal should a llow more precise measurements of duration and amplitude of the P wave , Data on reproducibility, filter settings, required number of beats, and precise definitions of onset and offset are dependent largely on t he system used, which can be QRS or, preferably, P wave triggered. Thi s explains conflicting data in the literature. It is clear that P wave duration is one of the best predictors of perioperative atrial fibril lation. For paroxysmal forms, the data are less convincing. Root mean square voltages of the P wave can be useful. Combining the P wave dura tion with other data often improves the diagnostic value of signal ave raging. Standardization of the techniques appears to be necessary.