CineECG provides a novel anatomical view on the normal atrial P-wave.

AIMS

Novel computed from standard 12-lead electrocardiogram (ECG) correlated the ventricular electric activity to ventricular anatomy. was never applied to reconstruct the spatial distribution of normal atrial electric activity into an atrial anatomic model.

METHODS AND RESULTS

From 6409 normal ECGs from PTB-XL database, we computed a median beat with fiducial points for P-and Q-onset. To determine the temporo-spatial location of atrial activity during PQ-interval, was computed on a normal 58-year-old male atrial/torso model. was projected to three major cardiac axes: posterior-anterior, right-left, base-roof, and to the standard cardiac four-chamber, left anterior oblique, and right anterior oblique (RAO) views. In 6409 normal subjects, during P-wave, moved homogeneously from right atrial roof towards left atrial base (-54 ± 14° in four-chamber view, 95 ± 24° RAO view). During terminal PQ-interval, the direction was opposite, moving towards left atrial roof (62 ± 27° in four-chamber view, 78 ± 27° RAO view). We identified the deflection point, where the atrial changes in direction. The time from P-onset to deflection point was similar to P-wave duration.

CONCLUSION

provided a novel three-dimensional visualization of atrial electrical activity during the PQ-interval, relating atrial electrical activity to the atrial anatomy. location during P-wave and terminal PQ-interval were homogeneous within normal controls. and its deflection point may enable the early detection of atrial conduction disorders predisposing to atrial arrhythmias.