Atrial fibrillatory wave characteristics on surface electrogram: ECG to ECG repeatability over twenty-four hours in clinically stable patients

Fibrillatory waves on the surface ECG have been scrutinized to allow inferences about underlying mechanisms and pathophysiology, based on the premise that fibrillatory waves do not vary "randomly" but provide a consistent reflection of the underlying state of the atria in an individual pat...

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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2004-08, Vol.15 (8), p.911-917
Main Authors: Xi, Qin, Sahakian, Alan V, Ng, Jason, Swiryn, Steven
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Atrial Fibrillation - diagnosis
Atrial Fibrillation - physiopathology
Diagnosis, Computer-Assisted - methods
Electrocardiography - methods
Female
Humans
Male
Middle Aged
Reproducibility of Results
Sensitivity and Specificity
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Summary:Fibrillatory waves on the surface ECG have been scrutinized to allow inferences about underlying mechanisms and pathophysiology, based on the premise that fibrillatory waves do not vary "randomly" but provide a consistent reflection of the underlying state of the atria in an individual patient. This premise is untested. Ten standard ECGs were recorded over a 24-hour period in each of 20 clinically stable inpatients with atrial fibrillation. After QRS-T cancellation, the remainder fibrillatory waves were analyzed. Interpatient versus intrapatient differences in fibrillatory wave characteristics were evaluated by analysis of variance (ANOVA). The fibrillatory wave peak-to-peak amplitude of all the patients ranged from 0.06 to 0.35 mV, whereas 1 SD of the amplitude for each patient ranged from 0.004 to 0.053 mV. Short-term peak frequencies of all the patients ranged from 4.6 to 8.0 Hz, whereas 1 SD for each patient varied from 0.2 to 0.5 Hz. For these and all other parameters tested, interpatient differences were significantly greater compared to intrapatient differences (P < 0.0001). Fibrillatory wave characteristics are repeatable from ECG to ECG over 24 hours for clinically stable patients, whereas substantial differences are present between patients. Further study of the relationship of such characteristics to pathophysiology and management decisions is valid and warranted.
ISSN:1045-3873
1540-8167
DOI:10.1046/j.1540-8167.2004.03577.x