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  • 1
    Electronic Resource
    Electronic Resource
    P Wave Dispersion: A Valuable Electrocardiographic Marker for the Prediction of Paroxysmal Lone Atrial Fibrillation (1999)
    Oxford, UK : Blackwell Publishing Ltd
    Annals of noninvasive electrocardiology 4 (1999), S. 0 
    Details
    ISSN: 1542-474X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The prolongation of atrial conduction time and the inhomogeneous propagation of sinus impulses are well known electrophysiological characteristics in patients with paroxysmal atrial fibrillation.Methods: The aim of this study was to test the ability of a new ECG marker to discriminate between patients with a prior history of paroxysmal lone atrial fibrillation and healthy controls. Maximum P wave duration (Pmax) and the difference between the maximum and the minimum P wave duration, which was defined as P-wave dispersion (Pdisp) were calculated from the 12-lead surface ECGs of 75 patients with a history of paroxysmal lone atrial fibrillation and 50 age-matched healthy controls.Results: Pmax was in patients 122 ± 17 ms and in controls 101 ± 10 ms (t = 7.935, P 〉 0.001). Pdisp was in patients 48 ± 16 ms and in controls 29 ± 8 ms (t = 7.616, P 〉 0.001). A Pmax value of 110 ms separated patients from controls with a sensitivity 85%, a specificity 72%, and a positive predictive accuracy of 82%. A Pdisp value of 40 ms separated patients from controls with a sensitivity of 81%, a specificity of 80%, and a positive predictive accuracy of 85%.Conclusions: (1) Pmax and Pdisp values were found to be significantly higher in patients with a prior history of paroxysmal lone atrial fibrillation than in age-matched healthy controls, and (2) Pdisp is a new simple ECG marker that could be possibly used for the identification of patients with a previous history of paroxysmal lone atrial fibrillation. A.N.E. 1999;4(1):39–45
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1542-474X.1999.tb00363.x
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  • 2
    Electronic Resource
    Electronic Resource
    Detection of Multivessel Disease Post Myocardial Infarction Using an Exercise-Induced QRS Score (2004)
    350 Main Street , Malden , MA 02148 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Annals of noninvasive electrocardiology 9 (2004), S. 0 
    Details
    ISSN: 1542-474X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective: The aim of this study was to investigate the ability of Athens QRS score values to detect stenoses in other coronary arteries than the obstructed ones (which caused the myocardial infarction [MI]) in patients with a history of MI. Methods: We studied 125 patients (93 males and 32 females, mean age 54 ± 7 years [range 45–68 years]) with a history of MI (46 patients with anterior MI, 54 patients with inferior MI, 25 patients with lateral MI). All patients underwent treadmill exercise testing and coronary arteriography. Results: Athens QRS score values were inversely related to the extent of CAD: −0.5 ± 0.3 mm for patients with 1-VD (obstructed vessel), −3.4 ± 2.2 mm for patients with 2-VD (obstructed vessel and stenosis in another vessel), and −5 ± 1.8 mm for patients with 3-VD (obstructed vessel and stenoses in two more vessels). The ROC curves for the detection of multivessel disease showed that the area under the curve for QRS score values 〈 −3 mm is significantly higher than the curve for ST-segment depression ≥1 mm (0.948 vs 0.792, P 〈 0.001). Conclusions: Values of the Athens QRS score less than −3 may distinguish single- from multivessel coronary artery disease in patients with a history of MI.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1542-474X.2004.93551.x
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  • 3
    Electronic Resource
    Electronic Resource
    Influence of Cigarette Smoking on Heart Rate Variability in Young Healthy Subjects (1999)
    Oxford, UK : Blackwell Publishing Ltd
    Annals of noninvasive electrocardiology 4 (1999), S. 0 
    Details
    ISSN: 1542-474X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Cigarette smoking is strongly related to decreased vagal cardiac activity and increased cardiac death. We sought to examine the short-term effects of smoking on heart rate variability (HRV) in healthy young subjects in the sitting position to investigate the influence of smoking on autonomic cardiac control.〈section xml:id="abs1-2"〉〈title type="main"〉MethodsThirty-two healthy volunteers (18 males, 14 females, 21 habitual smokers and 11 nonsmokers, mean age 30 ± 3 years, range 24–36 years) were studied. Smokers were asked not to smoke for 8 hours prior to examination. Mean, SDNN, rMSSD, pNN50, total power, LF, HF, and LF/HF ratio were measured for 30 minutes, divided into six periods of 5 minutes each. Smoking of a single cigarette took place during the second period.〈section xml:id="abs1-3"〉〈title type="main"〉ResultsSmoking caused a significant increase of the LF/HF ratio and of the normalized values of the LF component. A significant decrease in absolute values of total power, LF, and HF components was noticed. All time-domain indices were significantly decreased. We also noticed that although the changes appeared during smoking (second period) the maximal changes were documented 5 to 10 minutes after smoking cessation (third and fourth periods).〈section xml:id="abs1-4"〉〈title type="main"〉ConclusionsCigarette smoking in the sitting position causes a transient decrease in vagal cardiac control and a moderate sympathetic activation. These changes last for at least 30 minutes and are compatible with a modulation of the autonomic control of the sinoatrial node toward sympathetic predominance. Despite the differences concerning the baseline HRV measures between nonsmokers and habitual smokers, an almost identical pattern of sympathovagal modulation was observed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1542-474X.1999.tb00061.x
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  • 4
    Electronic Resource
    Electronic Resource
    Effects of Ischemia on P Wave Dispersion and Maximum P Wave Duration During Spontaneous Anginal Episodes (1999)
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 22 (1999), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: P wave dispersion (P dispersion), defined as the difference between the maximum and the minimum P wave duration, and maximum P wave duration (P maximum) are electrocardiographic (ECG) markers that have been used to evaluate the discontinuous propagation of sinus impulses and the prolongation of atrial conduction time, respectively. To study the effects of myocardial ischemia on P dispersion and P maximum, 95 patients with coronary artery disease (CAD) and typical angina pectoris and 15 controls with anginalike symptoms underwent 12-lead surface ECG during and after the relief of pain. During pain and during the asymptomatic period, P maximum and P dispersion were calculated from the averaged complexes of all 12 leads. P dispersion increased significantly during spontaneous angina (45 ± 17 ms) compared to the asymptomatic period (40 ± 15 ms), P 〈 0.001 only in the patient group. Both P maximum and P dispersion showed higher values during angina in those patients who developed diffuse ischemia, as estimated with ST segment changes in multiple ECG leads. P dispersion showed higher values during the anginal episode in patients with left ventricular dysfunction, independently of the presence of a previous myocardial infarction. Atrial conduction abnormalities, as estimated with P maximum and particularly P dispersion, are significantly influenced by myocardial ischemia in patients with CAD and spontaneous angina.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.1999.tb00384.x
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  • 5
    Electronic Resource
    Electronic Resource
    Increased Variance of P Wave Duration on the Electrocardiogram Distinguishes Patients with Idiopathic Paroxysmal Atrial Fibrillation (2000)
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 23 (2000), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We hypothesized that the variance of P wave duration (P variance) in the 12-lead ECG could reflect the spatial dispersion of P wave duration due to inhomogeneous and delayed propagation of sinus impulses in the atria, and moreover could present better reproducibility than maximum P wave duration and P wave dispersion that have already been used for the prediction of idiopathic paroxysmal AF, We also tested a semiautomated PC-based method to improve the accuracy and reproducibility of P wave measurements. A 12-lead ECG was obtained from 60 patients with idiopathic paroxysmal AF and from 50 healthy controls. All ECGs were analyzed manually using magnifying lens and calipers, while 20 randomly selected ones were scanned and analyzed on screen using common commercial software. P maximum, P dispersion, and P variance were all significantly higher in patients with paroxysmal AF than in controls. A P maximum value of 110 ms, a P dispersion value of 40 ms, and a P variance value of 120 ms2 separated patients from controls with a sensitivity of 88%, 83%, and 80%, respectively and a specificity of 75%, 85%, and 74%, respectively. The reproducibility of P variance was higher compared to P dispersion and P maximum. Finally, the PC-based method significantly increased accuracy and reproducibility of P wave measurements. Thus, the variance of P wave duration could be a useful ECG marker for the prediction of paroxysmal idiopathic AF and the use of PC-based methods may enhance the accurate measuring of P wave duration on the ECG.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.2000.tb00913.x
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  • 6
    Electronic Resource
    Electronic Resource
    Clinical and Electrocardiographic Predictors of Recurrent Atrial Fibrillation (2000)
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 23 (2000), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Patients with frequent episodes of paroxysmal atrial fibrillation (AF) are prone to develop permanent AF and have an increased thromboembolic risk. We have previously shown that P wave dispersion (P dispersion), defined as the difference between the maximum and the minimum P wave duration, and maximum P wave duration (P maximum) can distinguish patients with paroxysmal lone AF. The ability of those ECG markers and of other clinical and ECG variables to detect patients at risk for recurrent AF was tested in 88 patients, aged 64 ± 12 years. All patients had a history of symptomatic episodes of AF during the last 2 years and had not previously received any antiarrhythmic prophylaxis. P maximum and P dispersion were calculated from a 12-lead surface ECG recorded in all patients during sinus rhythm. A computerized ECG system was used and P maximum and P dispersion were calculated on screen from the averaged complexes of all 12 leads. Age (P=0.01), history of organic heart disease (P = 0.03), P maximum (P 〈 0.001), minimum P wave duration (P = 0.05), and P dispersion (P 〈 0.001) were found to be significant univariate predictors of recurrent AF, whereas only P maximum (P 〈 0.001) and age (P = 0.037) remained significant independent predictors of frequent AF paroxysms in the multivariatfi analysis. It is concluded that advanced age and prolonged P wave duration may be used as predictors of frequently relapsing AF. Therefore, simple AF predictors exist that could possibly distinguish the patients in whom prophylaxis with antiarrhythmic medicines should be instituted.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.2000.tb06761.x
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  • 7
    Electronic Resource
    Electronic Resource
    P Wave Analysis Indices in Young Healthy Men: Data from the Digital Electrocardiographic Study in Hellenic Air Force Servicemen (DEHAS) (2003)
    350 Main Street , Malden , MA 02148-5018 , USA . : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 26 (2003), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: GIALAFOS, E.J., et al.: P Wave Analysis Indices in Young Healthy Men. Data from the Digital Electrocardiographic Study in Hellenic Air Force Servicemen (DEHAS). P wave analysis from the 12-lead ECG is a recent contribution of noninvasive electrocardiology. P wave analysis indices (maximum and minimum P wave duration, P wave dispersion [Pdis= Pmax− Pmin], adjusted P wave dispersion [APdis= Pdis/√measured leads], summated P wave duration [Psum], standard deviation of P wave duration [Psd], mean P wave duration [Pmean]) can predict atrial arrhythmias. However, the definitions of all these indices are based on few studies. The aim of this analysis was to define normal values of these indices and the examine possible associations between P wave indices and clinical variables. The study included 1,353 healthy men, 24 ± 3 years of age, who answered a questionnaire and underwent a detailed physical examination and a digitized 12-lead surface ECG. All P wave indices were analyzed by two independent investigators. Mean values of the ECG indices were: Pmax: 96 ± 11 ms, Pmin: 57 ± 9 ms, Pdis: 38 ± 10 ms, Psum: 924 ± 96 ms, Psd: 12 ± 3,APdis: 11 ± 3 ms, and Pmean: 77 ± 8 ms . Age was significantly related with Pmax (r = 0.277, P 〈 0.01), Pmin (r = 0.255, P 〈 0.001), Psum (r = 0.074, P 〈 0.01), and Pmean (r = 0.074, P 〈 0.01) . All ECG indices were significantly associated with the R-R interval, and among each other. This study defined normal indices of wave duration and correlations among them. These markers may play an important predictive role in patients with atrial conduction abnormalities. (PACE 2003; 26[Pt. II]:367–372)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.00051.x
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