Jordaens L, Tavernier R, Gorgov N, Kindt H, Dimmer C, Clement D L
Department of Cardiology, University Hospital Ghent, University of Ghent, Belgium.
J Cardiovasc Electrophysiol. 1998 Aug;9(8 Suppl):S30-4.
Abnormalities of the P wave seen during sinus rhythm are associated with atrial fibrillation and other supraventricular arrhythmias. Intra-atrial conduction delays can be seen on the surface ECG as P wave prolongation, which is more visible with averaging techniques used in advanced recording devices. Averaging followed by amplification after proper filtering of the electrical signal should allow more precise measurements of duration and amplitude of the P wave. Data on reproducibility, filter settings, required number of beats, and precise definitions of onset and offset are dependent largely on the system used, which can be QRS or, preferably, P wave triggered. This explains conflicting data in the literature. It is clear that P wave duration is one of the best predictors of perioperative atrial fibrillation. For paroxysmal forms, the data are less convincing. Root mean square voltages of the P wave can be useful. Combining the P wave duration with other data often improves the diagnostic value of signal averaging. Standardization of the techniques appears to be necessary.
窦性心律时出现的P波异常与心房颤动及其他室上性心律失常有关。心房内传导延迟在体表心电图上可表现为P波延长，在先进记录设备中采用平均技术时更易观察到。对电信号进行适当滤波后进行平均并放大，应能更精确地测量P波的时限和振幅。关于可重复性、滤波设置、所需心搏数以及起始和终止的精确定义的数据，很大程度上取决于所使用的系统，该系统可以由QRS波触发，或者更理想地由P波触发。这就解释了文献中相互矛盾的数据。显然，P波时限是围手术期心房颤动的最佳预测指标之一。对于阵发性心房颤动，相关数据的说服力较弱。P波的均方根电压可能有用。将P波时限与其他数据相结合通常可提高信号平均的诊断价值。技术标准化似乎是必要的。
