title: P Wave Signal-Averaged Electrocardiography in Patients with Chronic Obstructive Pulmonary Disease.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is associated with higher incidence of supraventricular arrhythmias. Atrial late potentials (ALP) detected by P-wave signal-averaged electrocardiography (SAECG) could be useful in detecting the patients at risk for supraventricular arrhythmias. Our objective was to assess the role of P-wave SAECG and ALP detection for arrhythmic risk evaluation of the patients with exacerbated COPD.
  
  
  METHODS
  We prospectively included 45 patients with exacerbation of COPD and 58 age- matched patients with no history of pulmonary disease in a control group. We performed pulmonary function tests, arterial blood gases, echocardiography, 24-hour Holter monitoring and P-wave SAECG. We measured 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), and the integral of the potentials during the filtered P-wave (Integral-p). ALP was defined as FPD > 132 ms and RMS 20 < 2.3 μV.
  
  
  RESULTS
  Isolated atrial premature beats (APB) and supraventricular tachycardias (SVT) were more frequent in the COPD group. There were no significant differences between groups regarding the P wave SAECG parameters. In the COPD group none of the supraventricular arrhythmias was correlated with ALP or any P-wave SAECG parameters.
  
  
  CONCLUSIONS
  The patients with acute exacerbation of COPD but no apparent cardiac disease have a higher incidence of supraventricular arrhythmias. P-wave SAECG analysis and ALP detection have little value in the arrhythmic risk evaluation of these patients.
authors.forename: C A
authors.initials: CA
authors.lastname: Buzea
authors.forename: Anca Rodica
authors.initials: AR
authors.lastname: Dan
authors.forename: Caterina
authors.initials: C
authors.lastname: Delcea
authors.forename: M I
authors.initials: MI
authors.lastname: Balea
authors.forename: Daniela
authors.initials: D
authors.lastname: Gologanu
authors.forename: Mihaela
authors.initials: M
authors.lastname: Dobranici
authors.forename: Raluca Alexandra
authors.initials: RA
authors.lastname: Popescu
authors.forename: G A
authors.initials: GA
authors.lastname: Dan
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*