Michelucci A, Padeletti L, Chelucci A, Mezzani A, Porciani M C, Caruso F, Lebrun E, Bacci F, Martelli M, Gensini G F
Clinical Medica I e Cardiologia, University of Florence, Italy.
Pacing Clin Electrophysiol. 1996 May;19(5):758-67. doi: 10.1111/j.1540-8159.1996.tb03357.x.
Signal-averaged P wave of 42 patients with lone paroxysmal atrial fibrillation (PAF) and 29 normal subjects (N) were recorded, using three orthogonal leads and analyzed in the time and frequency (entire P wave or a 100-ms segment ranging from 75 ms before to 25 ms after the end of P wave) domains. PAFs were divided into a group of 12 having > or = 2 attacks a month (HF) and a group of 30 having < or = 2 attacks a year (LF). Statistically significant differences were absent with regard to ages of PAF and N; ages of HF, LF, and N at the time of signal-averaged ECG; ages of HF and LF at the time of the first arrhythmic episode; and elapsed times from the first episode. Length of P wave and some frequency-domain parameters were found to be significantly correlated with age. PAF showed a significantly longer duration of P wave in the frontal plane using the time-domain analysis. Frequency analysis was found to be useful in evaluating the influence of attack frequency. HF showed significantly higher values of some frequency-domain parameters than LF and N, while the three groups did not differ for time-domain analysis. P wave duration and frequency content of the three orthogonal leads proved to be significantly different in PAF and N. Right and left atrial echocardiographic dimensions proved to be higher (even if within normal limits) in HF than in LF and N. Results suggest that frequency analysis should be performed on the entire P wave.
记录了42例孤立性阵发性心房颤动（PAF）患者和29例正常受试者（N）的信号平均P波，使用三个正交导联，并在时间和频率（整个P波或从P波结束前75毫秒到结束后25毫秒的100毫秒段）域进行分析。PAF患者分为两组，一组为每月发作≥2次（高频组，HF），另一组为每年发作≤2次（低频组，LF）。PAF组与正常组在年龄方面无统计学显著差异；信号平均心电图检查时HF组、LF组和正常组的年龄；首次心律失常发作时HF组和LF组的年龄；以及自首次发作以来的时间。发现P波长度和一些频域参数与年龄显著相关。使用时域分析发现，PAF患者额面P波持续时间明显更长。发现频率分析有助于评估发作频率的影响。HF组某些频域参数的值明显高于LF组和正常组，而三组在时域分析中无差异。PAF组和正常组三个正交导联的P波持续时间和频率成分被证明有显著差异。HF组右心房和左心房超声心动图尺寸（即使在正常范围内）高于LF组和正常组。结果表明，应在整个P波上进行频率分析。
