T. Yamada et al., Identification of sinus node dysfunction by use of P-wave signal-averaged electrocardiograms in paroxysmal atrial fibrillation: A prospective study, AM HEART J, 142(2), 2001, pp. 286-293
Citations number
28
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Background In patients with paroxysmal atrial fibrillation (Paf), the ident
ification of the coexistence of sinus node dysfunction (SND) has therapeuti
c implications. This study sought to prospectively determine whether SND in
patients with Paf would be identified by use of atrial early potential (EP
), low-amplitude potentials early in signal-averaged P wave.
Methods The study population consisted of 149 patients with Paf. Signal-ave
raged electrocardiography was recorded with the P-wave-triggering technique
. The root mean square voltage for the initial 30 MS and the duration of in
itial low-amplitude signals <4 <mu>V of signal-averaged P wave were measure
d in the vector magnitude. The criteria of EP were defined as "the root mea
n square voltage for the initial 30 MS <3.0 <mu>V and the duration of initi
al low-amplitude signals <4 <mu>V >22 MS." SND was diagnosed by use of the
conventional 12-lead electrocardiography, 24-hour Halter monitoring, and be
dside electrocardiographic monitoring.
Results Thirty-eight of 149 patients with Paf had EP. Eighteen (47%) of 38
patients with Paf and EP had SND, whereas SND was found in only 5 (5%) of t
he other 111 patients with Paf without EP (P<.0001). EP gave a sensitivity
of 78% and a specificity of 84% for the defection of SND in patients with P
af.
Conclusion EP would be useful for the identification of SND in patients wit
h Paf.