title: P-wave complexity in normal subjects and computer models.
abstract: P waves reported in electrocardiology literature uniformly appear smooth. Computer simulation and signal analysis studies have shown much more complex shapes.
  
  
  
  We systematically investigated P-wave complexity in normal volunteers using high-fidelity electrocardiographic techniques without filtering.
  
  
  
  We recorded 5-min multichannel ECGs in 16 healthy volunteers. Noise and interference were reduced by averaging over 300 beats per recording. In addition, normal P waves were simulated with a realistic model of the human atria.
  
  
  
  Measured P waves had an average of 4.1 peaks (range 1-10) that were reproducible between recordings. Simulated P waves demonstrated similar complexity, which was related to structural discontinuities in the computer model of the atria.
  
  
  
  The true shape of the P wave is very irregular and is best seen in ECGs averaged over many beats.
authors.affiliation: Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands. Electronic address: mark@potse.nl.
authors.forename: Mark
authors.initials: M
authors.lastname: Potse
authors.affiliation: Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands.
authors.forename: Theo A R
authors.initials: TA
authors.lastname: Lankveld
authors.affiliation: Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands.
authors.forename: Stef
authors.initials: S
authors.lastname: Zeemering
authors.affiliation: Department of Epidemiology, Maastricht University; CARIM School for Cardiovascular Diseases, Maastricht University; CAPHRI School for Public Health and Primary Care, Maastricht University.
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Dagnelie
authors.affiliation: CARIM School for Cardiovascular Diseases, Maastricht University; Department of Internal Medicine, Maastricht University Medical Centre.
authors.forename: Coen D A
authors.initials: CD
authors.lastname: Stehouwer
authors.affiliation: CARIM School for Cardiovascular Diseases, Maastricht University; Department of Internal Medicine, Maastricht University Medical Centre.
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Henry
authors.affiliation: Heart Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: André C
authors.initials: AC
authors.lastname: Linnenbank
authors.affiliation: Department of Biomedical Engineering, Cardiovascular Research Institute Maastricht, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands.
authors.forename: Nico H L
authors.initials: NH
authors.lastname: Kuijpers
authors.affiliation: Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Universiteitssingel 50, 6229 ER Maastricht, The Netherlands.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schotten
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D003198:Computer Simulation; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006329:Heart Conduction System / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D009426:Netherlands; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Computer models; Electrocardiogram; Filtering; Interatrial block; P wave; Recording techniques