The signal-averaged electrocardiogram of atrial activation in patients with or without paroxysmal atrial fibrillation.
OBJECTIVE
To analyze the parameters of the time domain P-wave signal-averaged electrocardiogram (P-SAECG) and compare them with the P-wave duration on the conventional electrocardiogram (P on ECG) as well as the left atrium diameter (LAD) and left ventricular ejection fraction (EF) obtained on the echocardiogram in order to evaluate patients with paroxysmal atrial fibrillation (PAF).


METHODS
One hundred and eighty-one patients were included in the study: 117 with confirmed PAF and 64 without PAF. The P-SAECG parameters used were: the filtered P-wave duration (FPD), the root mean square (RMS) voltages in the last 40, 30 and 20 ms of the filtered P-wave (RMS 40, RMS 30 and RMS 20), the root mean square voltage of the filtered P-wave potentials (RMS P), the integral of the potentials during the filtered P-wave (Integral P) and the filtered P-wave late potential durations below 3 microV (PL<3).


RESULTS
The parameters that presented significant statistical differences between the groups were: FPD, RMS 40, 30 and 20, PL<3, P on ECG and LAD. The ROC curve calculations demonstrated the best cut-off points and performance estimates for each parameter: sensitivity, specificity, area under the curve and p-value (p).


CONCLUSIONS
The time domain P-SAECG proved to be a superior method to identify patients with paroxysmal atrial fibrillation than the conventional electrocardiogram and echocardiogram.
Moreira
José Osvaldo
JO
Instituto do Coração do Hospital das Clínicas, FM, USP, São Paulo, SP, Brazil.
Moffa
Paulo Jorge
PJ
Uchida
Augusto Hiroshi
AH
Tobias
Nancy Maria Martins de Oliveira
NM
Grupi
César José
CJ
Luna Filho
Bráulio
B
Tarasoutchi
Flávio
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology; D016275:Atrial Function / Q000502:physiology*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted