Use of P-wave-triggered, P-wave signal-averaged electrocardiogram to predict atrial fibrillation after coronary artery bypass surgery

Klein, Morey; Evans, Steven J.; Blumberg, Stephen; Cataldo, Lorenzo; Bodenheimer, Monty M.

doi:10.1016/0002-8703(95)90109-4

Cited by 94 publications

(57 citation statements)

References 17 publications

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“…Interestingly, the sensitivity and specificity were both similar to those obtained by STEINBERG, 1993 14 and KLEIN, 1995 15 for p wave duration measured by high resolution EKG. Among the four patients presenting with SACT longer than 96ms in this study, only one had documented post-operative AF.…”

Section: Discussionsupporting

confidence: 83%

Sinus node function in patients operated for mitral valve disease: indirect evaluation with epimyocardial electrodes

et al. 2008

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Purpose: To study the interatrial conduction times and atrial node performance in patients submitted to mitral valve surgery with the aid of temporary atrial epicardic electrodes. Methods: The atriograms were carried out in the first postoperative day and before the hospital discharge of ten consecutive patients. Results: Sixty percent of the patients could complete the post-operative study protocol. The main results were: a) Post-operative arrhythmias were detected in 50% of the patients; b) There were no statistical differences between the pre and post-operative 12 lead EKGs. c) The interatrial conduction time (IACT) ranged from 90 to 140ms in the first post-operative day, and from 110 to 130ms at hospital discharge; d) The sinus node recovery time (SNRT) ranged from 250 to 560 ms in the first post-operative day and from 180 to 360ms at hospital discharge; e) The sinus atrial conduction time (SACT) remained between 70 and 140ms, both in the first post-operative day and at hospital discharge, and; f) The IACT was normal in patients whose left atrium (LA) was less than 50mm in diameter but supra normal in the remaining cases. Conclusions: Sinus node function and inter-atrial conduction are not altered by mitral valve operation. Post-operative programmed epicardic atrial stimulation is easy and safe.Key words: Epicardial. Atriograms. Atrial Arrhythmias. Mitral Valve Disease. Cardiac Surgery. RESUMOObjetivo: Estudar os tempos de condução interatrial e a função do nó sinusal em pacientes submetidos a tratamento cirúrgico. Métodos: Foram estudados 10 pacientes adultos consecutivos submetidos à operação de correção de valvopatia mitral. Registraram-se atriogramas usando eletrodos epimiocárdicos cirurgicamente implantados. Os atriogramas foram obtidos no primeiro dia do pós-operatório e antes da alta hospitalar. Resultados: Os principais achados foram: a) A incidência de arritmias atriais até alta hospitalar foi de 50 %; b) O tempo de condução interatrial (TCIA) variou de 90 a 140 ms no 1°PO e 110 a130 ms antes da alta hospitalar; c) O tempo de recuperação do nó sinusal (TRNS) variou de 250 a 560 ms no 1°PO e180 a 360 ms antes da alta hospitalar; d) O tempo de condução sinoatrial (TCSA) variou de 70 a 140 ms tanto no 1ºPO, como antes da alta hospitalar e; d) O tempo de condução interatrial (TCIA) foi normal em pacientes com átrio esquerdo menores do que 50 mm e supranormal nos outros casos. Conclusão: As funções do nó sinusal e a condução interatrial não foram alteradas pelo tratamento cirúrgico da valvopatia mitral. A estimulação atrial epicárdica programada é segura de fácil realização.Descritores: Epicárdio. Atriogramas. Arritmias Atriais. Valvopatia Mitral. Cirurgia Cardíaca.

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Section: Discussionsupporting

confidence: 83%

Sinus node function in patients operated for mitral valve disease: indirect evaluation with epimyocardial electrodes

et al. 2008

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“…Prolongation of maximum P-wave duration and increased P dispersion are thought to be indicators of interatrial conduction disturbance and are often used to predict paroxysmal atrial fibrillation (9,10). Assessment of Pmax following secundum atrial septal defect closure may reveal the effects of atrial septal defect devices on electrical in homogeneity.…”

Section: Introductionmentioning

confidence: 99%

Analysis of maximum P-wave duration and dispersion after percutaneous closure of atrial septal defects: Comparison of two septal occluders

Paç¹,

Ballı²,

Topaloğlu³

et al. 2012

Anadolu Kardiyol Derg

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“…In this context, P-wave signalaveraged electrocardiography proved to be a noninvasive, low-cost, easily performed and reproducible method; therefore, it has been widely used in the evaluation and stratification of the risk of atrial fibrillation [16][17][18][19][20][21][22][23][24][25][26][27] .…”

Section: Discussionmentioning

confidence: 99%

Atrial activation during sinus rhythm in patients with rheumatic and non-rheumatic paroxysmal atrial fibrillation. Frequency-domain analysis using signal-averaged electrocardiography

Dantas¹,

Barbosa²,

Benchimol-Barbosa³

et al. 2001

Arq. Bras. Cardiol.

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Objective -Using P-wave signal-averaged electrocardiography, we assessed the patterns of atrial electrical activation in patients with idiopathic atrial fibrillation as compared with patterns in patients with atrial fibrillation associated with structural heart disease. Atrial fibrillation is the most common sustained arrhythmia diagnosed in clinical practice [1][2][3][4] . In the general population, its prevalence increases with age: it is lower than 1% in the age bracket from 40 to 65 years, ranges from 2% to 5% in the age bracket from 65 to 74 years, and is higher than 5% above the age of 75 years. No difference in incidence has been observed between the sexes 1 . The increase in prevalence and incidence of atrial fibrillation with age is mainly associated with coexisting cardiac diseases. However, an independent effect of direct ageing on the atrial tissue cannot be excluded 5 . Methods -Eighty patients with recurrent paroxysmalA history of congestive heart failure, rheumatic valvar disease, left ventricular hypertrophy, and left atrial enlargement are independent risk factors associated with the genesis of atrial fibrillation. The presence of this arrhythmia in structurally normal hearts, although infrequent, may be detected in clinical practice. The triggering and maintenance factors of idiopathic atrial fibrillation are not very well defined. However, a significant number of patients with the paroxysmal or persistent form of atrial fibrillation, even though without evidence of anatomical cardiac alterations, evolve towards chronic atrial fibrillation. Such patients include those with structural heart disease despite the use of antiarrhythmic drugs. The objective of our study was to identify the electrophysiological behavior of atrial activation in patients with paroxysmal or persistent atrial fibrillation, through the use of P-wave signal-averaged electrocardiography for frequency-domain analysis. MethodsIn a cross-sectional study, we analyzed 80 patients who were being followed up in the outpatient cardiac arrhythmia care unit of the Hospital Universitário Pedro Ernesto. These patients had a history of at least 2 episodes of paroxysmal or persistent atrial fibrillation confirmed on electrocardiography in the last year, and they had not used any antiarrhythmic drug for at least 5 half-lives of each drug in

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Use of P-wave-triggered, P-wave signal-averaged electrocardiogram to predict atrial fibrillation after coronary artery bypass surgery

Cited by 94 publications

References 17 publications

Sinus node function in patients operated for mitral valve disease: indirect evaluation with epimyocardial electrodes

Sinus node function in patients operated for mitral valve disease: indirect evaluation with epimyocardial electrodes

Analysis of maximum P-wave duration and dispersion after percutaneous closure of atrial septal defects: Comparison of two septal occluders

Atrial activation during sinus rhythm in patients with rheumatic and non-rheumatic paroxysmal atrial fibrillation. Frequency-domain analysis using signal-averaged electrocardiography

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