[Detection of patients at risk for paroxysmal atrial fibrillation (PAF) by signal averaged P wave, standard ECG and echocardiography].
The aim of this study was to evaluate whether analysis of signal averaged P wave, together with left atrial diameter (LA) and P wave duration in surface ECG lead II (PII) allow to predict the risk of PAF.


METHODS
Patients with coronary heart disease and/or hypertension were examined (n=145). They were divided into two groups 110 patients with PAF were compared with 35 patients without PAF Age (60,5 vs. 57,4 years) and LA size (39,8 vs. 3,7 mm) were similar in two groups.


RESULTS
The root mean square voltage (RMS) for the last 10,20, 30 ms were calculated and for all of the filtered P wave (RMSW) were measured RMS ratio (RMSR) were calculated according to RMSW/ RMS20. Filtered P wave duration (PWD) and difference befteen PWD and P II (PWD-PII) were established. Most of the analyzed parameters were statistically significant (p<0,05). The statistical analyses made it possible to outline the score index evaluating how PAF reacts parameters.


CONCLUSIONS
Score index evaluating of the PAF occurrence and its influence is statistically significant with sensitivity 86%, specificity 83,5% and index positive predictor 82,7% and index negative predictor 83,7%. The most significant parameters which detect the patients with the occurrence of PAF are PWD > or =130ms, RMS20<3, microV, RMS10<2,2 microV and PWD-PII > or =40 ms.
Michałkiewicz
Dariusz
D
Wojskowy Instytut Medyczny w Warszawie, Klinika Chorób Wewnetrznych i Kardiologii CSK MON. dariuszmichalkiewicz@neostrada.pl
Dziuk
Mirosław
M
Kamiński
Grzegorz
G
Olszewski
Robert
R
Cholewa
Marian
M
Cwetsch
Andrzej
A
Markuszewski
Leszek
L
D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors
D000889:Anti-Arrhythmia Agents; D000638:Amiodarone