Ogawa H, Inoue T, Yoshida A, Doi T, Ohga N, Ohnishi Y, Yokoyama M
First Department of Internal Medicine, Kobe University, School of Medicine, Japan.
Jpn Heart J. 1993 Jan;34(1):29-39. doi: 10.1536/ihj.34.29.
To evaluate the significance of the signal-averaged P wave in various pathological conditions of the atrium, signal-averaged electrocardiograms and echocardiograms were studied in the following 4 groups: (1) 10 normal subjects (control group), (2) 24 patients with paroxysmal atrial fibrillation or flutter (AF) (AF group), (3) 12 patients with left atrial overload without AF (LA group), and (4) 10 patients with right atrial overload without AF (RA group). Original P wave durations showed no significant difference among the 4 groups. Filtered P wave durations (F-PDs) in the AF and LA groups were significantly longer than that in the control group. F-PD correlated significantly with left atrial dimension (LAD). F-PD in AF patients with LAD shorter than 40 mm was significantly longer than that in the control group, but there was no significant difference in F-PD between AF patients with LAD longer than 40 mm and the LA group. Root mean square voltages of original P waves were significantly higher in the LA and RA groups than that in the control group, but in AF patients it did not differ from that in the control group. In conclusion, the signal-averaged P wave is useful to predict atrial fibrillation, but prolongation of F-PD is seen not only in patients with AF but also in patients with LA overload.
为评估心房不同病理状态下信号平均P波的意义，对以下4组患者进行了信号平均心电图和超声心动图研究：（1）10名正常受试者（对照组）；（2）24例阵发性心房颤动或心房扑动（AF）患者（AF组）；（3）12例无AF的左心房负荷过重患者（LA组）；（4）10例无AF的右心房负荷过重患者（RA组）。4组患者的原始P波时限无显著差异。AF组和LA组的滤波后P波时限（F-PD）显著长于对照组。F-PD与左心房内径（LAD）显著相关。LAD短于40mm的AF患者的F-PD显著长于对照组，但LAD长于40mm的AF患者与LA组的F-PD无显著差异。LA组和RA组原始P波的均方根电压显著高于对照组，但AF患者与对照组无差异。总之，信号平均P波有助于预测心房颤动，但F-PD延长不仅见于AF患者，也见于LA负荷过重患者。
