Electrocardiographic detection of left atrial enlargement. Correlation of P wave with left atrial dimension by echocardiography.

Chirife, Raúl; Feitosa, Gílson Soares; Frankl, William S.

doi:10.1136/hrt.37.12.1281

Cited by 62 publications

(24 citation statements)

References 14 publications

(21 reference statements)

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“…8,11 The duration of atrial activation (Pd), QRS complex duration (QRSd), and the PR interval were calculated using the medians of onset and end times in all averaged channels as described earlier. 12,13 In addition, the root mean square (RMS) amplitudes of the magnetic field strength over the whole atrial complex and last 40 ms of atrial depolarization were automatically determined. 12,13 In addition, the root mean square (RMS) amplitudes of the magnetic field strength over the whole atrial complex and last 40 ms of atrial depolarization were automatically determined.…”

Section: Mcg and Signal-averaged Ecgmentioning

confidence: 99%

High‐Resolution Signal‐Averaged Analysis of Atrial Electromagnetic Characteristics in Patients with Paroxysmal Lone Atrial Fibrillation

Jurkko¹,

Väänänen²,

Mäntynen³

et al. 2008

Noninvasive Electrocardiol

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Section: Mcg and Signal-averaged Ecgmentioning

confidence: 99%

High‐Resolution Signal‐Averaged Analysis of Atrial Electromagnetic Characteristics in Patients with Paroxysmal Lone Atrial Fibrillation

Jurkko¹,

Väänänen²,

Mäntynen³

et al. 2008

Noninvasive Electrocardiol

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“…Multiple criteria have been established for the diagnosis of LAE 3–4. Both quantitative (P duration >110 ms in lead II, P to PR segment ratio >1.6 in lead II, P wave area > 4 ms × mV in lead II, and the P terminal force in lead V1 [PTFV1] > 40 ms × mm) and qualitative (bifid P wave in lead II, and biphasic P wave in V1) measures of LAE have been described to be a surrogate marker for LAE on surface ECG 5–9. P duration >110 ms and P to PR segment ratio have both been shown to be correlated with LAE 5–8.…”

Section: Introductionmentioning

confidence: 99%

“…Both quantitative (P duration >110 ms in lead II, P to PR segment ratio >1.6 in lead II, P wave area > 4 ms × mV in lead II, and the P terminal force in lead V1 [PTFV1] > 40 ms × mm) and qualitative (bifid P wave in lead II, and biphasic P wave in V1) measures of LAE have been described to be a surrogate marker for LAE on surface ECG 5–9. P duration >110 ms and P to PR segment ratio have both been shown to be correlated with LAE 5–8. The P wave area, defined as amplitude × ½ duration, has a high sensitivity and specificity for diagnosis of LAE in patients with mitral stenosis when the cutoff value of > 4 ms × mV was used 10.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of electrocardiographic parameters as compared with computed tomography measures of left atrial volume enlargement: from the ROMICAT trial

Truong

Charipar

Ptaszek

et al. 2011

Journal of Electrocardiology

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Introduction The twelve-lead surface electrocardiogram (ECG) is commonly used as a non-invasive modality to assess for left atrial enlargement (LAE), but data comparing ECG against cardiac computed tomography (CT) for LAE is lacking. We aimed to determine the diagnostic performance of six ECG criteria for LAE as compared to CT left atrial volume (LAV) and index to body surface area (LAVI) as the reference standard. Materials and Methods In 339 patients (age 53±12 years, 63% male), we evaluated the quantitative ECG parameters of P duration, P to PR segment ratio, P wave area, and P terminal force (PTFV1). We also assessed qualitatively the morphology of bifid and biphasic P waves. Patients were stratified into top and lowest quartile of LAV and LAVI by CT. Results Of the six ECG criteria, patients with P duration>110 ms had a 2½-fold increase likelihood of being in the top quartile of LAV (adjusted odds ratio [OR] OR 2.51, p=0.01) and LAVI (adjusted OR 2.74; p=0.007) as measured by CT. For this ECG criterion, the sensitivity and specificity were 71% and 55% for CT LAE by LAV and 61% and 55% for LAVI. The remaining ECG parameters of LAE assessed (P to PR segment ratio, PTFV1, P wave area, bifid, and biphasic P wave) were not associated with LAE by CT-based LAV or LAVI (all p≥0.20). Discussion Only P duration>110 ms was independently associated with LAE based on CT-derived LA volume and index. However, none of the established ECG parameters of LAE have sufficient diagnostic accuracies for predicting volumetric enlargement by CT, thus limiting its clinical utility.

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“…Whilst echo measurements of left atrial size have been shown to correlate well with left atrial volumes determined by angiography (Hirata et al, 1969;Ten Cate et al, 1974), there is little information on how reliable each technique is in detecting left atrial enlargement in the purely clinical situation (Termini and Yu-Chen Lee, 1975;Chirife, Feitosa and Franki, 1975).…”

Section: Introductionmentioning

confidence: 99%

The non-invasive recognition of left atrial enlargement: comparison of electro- and echocardiographic measurements

Ikram

Drysdale

Bones

et al. 1977

Postgraduate Medical Journal

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SummaryThe aim of this study was to compare the ability of electro-and echocardiography to detect enlargement of the left atrium. Seventy-four patients, divided into three groups (eighteen normal, thirty-six valvular disease, twenty hypertension and/or coronary artery disease) were studied. The P wave terminal force in lead V1 (PTF-V1) was measured from a standard 12 lead electrocardiogram, and the internal left atrial dimension (LAD) was measured from time-motion echocardiograms. Linear regression analysis showed a small but significant linear correlation between PTF-V1 and LAD (r = 0-32, P < 0 01). Both methods would separate patients with diseases known to cause left atrial enlargement from normals, but echocardiography showed greater 'specificity ' (100%O v. 94°o) and 'sensitivity' (75%4 v. 67%). It was much superior to the ECG in detecting milder grades of left atrial enlargement and for following serial changes.

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Electrocardiographic detection of left atrial enlargement. Correlation of P wave with left atrial dimension by echocardiography.

Cited by 62 publications

References 14 publications

High‐Resolution Signal‐Averaged Analysis of Atrial Electromagnetic Characteristics in Patients with Paroxysmal Lone Atrial Fibrillation

High‐Resolution Signal‐Averaged Analysis of Atrial Electromagnetic Characteristics in Patients with Paroxysmal Lone Atrial Fibrillation

Usefulness of electrocardiographic parameters as compared with computed tomography measures of left atrial volume enlargement: from the ROMICAT trial

The non-invasive recognition of left atrial enlargement: comparison of electro- and echocardiographic measurements

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