Havmöller Rasmus, Carlson Jonas, Holmqvist Fredrik, Olsson Bertil, Platonov Pyotr
Department of Cardiology, Lund University, Lund, Sweden.
Ann Noninvasive Electrocardiol. 2009 Jul;14(3):226-33. doi: 10.1111/j.1542-474X.2009.00301.x.
Orthogonal P-wave morphology in healthy men and women has been described using unfiltered signal-averaged technique and holds information on interatrial conduction. The stability of P-wave morphology in healthy subjects over time is not fully known.
Sixty-seven healthy volunteers were investigated (29 males, aged 63 +/- 14 years, 48 females, 60 +/- 13 years). Orthogonal lead data (X, Y, and Z) were derived from standard 12-lead ECGs (recording length 6 minutes, sampling rate 1kHz, resolution 0.625 muV) recorded at baseline (BL), and 3 years later at follow-up (FU). P waves were then signal-averaged and analyzed regarding P-wave morphology, locations of maxima, minima, zero-crossings, and P-wave duration (PWD).
No differences of P-wave variables were observed at FU compared to BL, including PWD (127 +/- 12 vs 125 +/- 14 ms at BL and FU, respectively, n.s.). In 59 of the 67 subjects (88%), the P-wave morphology was unaltered at FU. However, in the remaining eight cases a distinctively different morphology was observed. The most common change (P=0.030) was from negative polarity to biphasic (-/+) in Lead Z (n=5). In one case the opposite change was observed and in two cases transition into advanced interatrial block morphology was evident at FU.
In the majority of healthy subjects, P-wave morphology is stable at 3-year FU. Subtle morphological changes, observed principally in Lead Z, suggest variation of interatrial conduction. These changes could not be detected by measuring conventional PWD that remained unchanged in the total population.
已使用未滤波的信号平均技术描述了健康男性和女性的正交P波形态，其包含心房传导信息。健康受试者P波形态随时间的稳定性尚不完全清楚。
对67名健康志愿者进行了研究（29名男性，年龄63±14岁，48名女性，60±13岁）。正交导联数据（X、Y和Z）来自基线（BL）时记录的标准12导联心电图（记录长度6分钟，采样率1kHz，分辨率0.625μV），以及3年后随访（FU）时的记录。然后对P波进行信号平均，并分析P波形态、最大值、最小值、零交叉点的位置以及P波持续时间（PWD）。
与BL相比，FU时未观察到P波变量的差异，包括PWD（BL和FU时分别为±12和±14ms，无统计学意义）。在67名受试者中的59名（88%）中，FU时P波形态未改变。然而，在其余8例中观察到明显不同的形态。最常见的变化（P=0.030）是Z导联中从负极性变为双相性（-/+）（n=5）。在1例中观察到相反的变化，在2例中FU时明显转变为晚期心房传导阻滞形态。
在大多数健康受试者中，3年随访时P波形态稳定。主要在Z导联观察到的细微形态变化提示心房传导存在变异。通过测量在总体人群中保持不变的传统PWD无法检测到这些变化。
