Reproducibility of the signal averaged P wave: time and frequency domain analysis. 1997

P J Stafford, and J Cooper, and J Fothergill, and F Schlindwein, and D P deBono, and C J Garratt
Department of Cardiology, Glenfield Hospital, Leicester, United Kingdom.

OBJECTIVE To assess the reproducibility of time and frequency domain variables derived from the signal averaged P wave. METHODS Longitudinal within patient study. METHODS Regional cardiothoracic centre. METHODS 20 patients (10 with documented paroxysmal atrial fibrillation and 10 normal controls) were studied on three occasions to assess the reproducibility of repeated signal averaged P wave recordings. Digital P wave recordings were made on a further 10 patients on a single occasion and the recordings signal averaged twice in order to assess the reproducibility of the averaging system itself in the absence of biological variation. METHODS P wave duration, spatial velocity, and energies contained in frequency bands from 20, 30, and 60-150 Hz of the P wave spectrum were measured after P wave specific signal averaging. Coefficients of reproducibility were calculated for paired signal averaged P waves derived by signal averaging the same digital recordings on two separate occasions, for recordings performed in the same patients immediately after each other ("back to back") and those performed one week apart. RESULTS System reproducibility when the same digital P wave recordings were signal averaged on two separate occasions was high (< 11% for all variables). For P wave duration the coefficient of reproducibility was 11.4% for back to back recordings and 13.1% for those one week apart. The reproducibility of spatial velocity and P wave energy was low. Variation in P wave morphology was noted when successive P waves from the same subject were examined. If recordings with the same P wave morphology were analysed the reproducibility of spatial velocity and P wave energy improved but remained significantly poorer than that for P wave duration. CONCLUSIONS P wave duration is reproducible within subjects in the short and medium term. Frequency domain and spatial velocity analysis are poorly reproducible, due more to spontaneous variation in P wave morphology than to instability of the signal averaging process. This may limit the utility of signal averaged P wave variables other than duration for the prediction of atrial arrhythmia.

UI MeSH Term Description Entries
D008137 Longitudinal Studies Studies in which variables relating to an individual or group of individuals are assessed over a period of time. Bogalusa Heart Study,California Teachers Study,Framingham Heart Study,Jackson Heart Study,Longitudinal Survey,Tuskegee Syphilis Study,Bogalusa Heart Studies,California Teachers Studies,Framingham Heart Studies,Heart Studies, Bogalusa,Heart Studies, Framingham,Heart Studies, Jackson,Heart Study, Bogalusa,Heart Study, Framingham,Heart Study, Jackson,Jackson Heart Studies,Longitudinal Study,Longitudinal Surveys,Studies, Bogalusa Heart,Studies, California Teachers,Studies, Jackson Heart,Studies, Longitudinal,Study, Bogalusa Heart,Study, California Teachers,Study, Longitudinal,Survey, Longitudinal,Surveys, Longitudinal,Syphilis Studies, Tuskegee,Syphilis Study, Tuskegee,Teachers Studies, California,Teachers Study, California,Tuskegee Syphilis Studies
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001281 Atrial Fibrillation Abnormal cardiac rhythm that is characterized by rapid, uncoordinated firing of electrical impulses in the upper chambers of the heart (HEART ATRIA). In such case, blood cannot be effectively pumped into the lower chambers of the heart (HEART VENTRICLES). It is caused by abnormal impulse generation. Auricular Fibrillation,Familial Atrial Fibrillation,Paroxysmal Atrial Fibrillation,Persistent Atrial Fibrillation,Atrial Fibrillation, Familial,Atrial Fibrillation, Paroxysmal,Atrial Fibrillation, Persistent,Atrial Fibrillations,Atrial Fibrillations, Familial,Atrial Fibrillations, Paroxysmal,Atrial Fibrillations, Persistent,Auricular Fibrillations,Familial Atrial Fibrillations,Fibrillation, Atrial,Fibrillation, Auricular,Fibrillation, Familial Atrial,Fibrillation, Paroxysmal Atrial,Fibrillation, Persistent Atrial,Fibrillations, Atrial,Fibrillations, Auricular,Fibrillations, Familial Atrial,Fibrillations, Paroxysmal Atrial,Fibrillations, Persistent Atrial,Paroxysmal Atrial Fibrillations,Persistent Atrial Fibrillations
D012815 Signal Processing, Computer-Assisted Computer-assisted processing of electric, ultrasonic, or electronic signals to interpret function and activity. Digital Signal Processing,Signal Interpretation, Computer-Assisted,Signal Processing, Digital,Computer-Assisted Signal Interpretation,Computer-Assisted Signal Interpretations,Computer-Assisted Signal Processing,Interpretation, Computer-Assisted Signal,Interpretations, Computer-Assisted Signal,Signal Interpretation, Computer Assisted,Signal Interpretations, Computer-Assisted,Signal Processing, Computer Assisted

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