Global P wave duration on the 65-lead ECG: single-site and dual-site pacing in the structurally normal human atrium.

Abstract:

INTRODUCTION:Pacing is believed to prevent atrial fibrillation by reducing atrial activation time. Exact correlation between P wave duration (PWD) on surface ECG and endocardial atrial activation time is still unexplored. METHODS AND RESULTS:In 15 patients without structural heart disease (9 women, age 45 +/- 14 years), single site [high right atrium (HRA), coronary sinus ostium (CSos), distal CS (CSd), high RA septum (Bachmann's bundle, BB)] and dual-site pacing (various combinations) was performed after ablation of supraventricular tachycardia. A 65-lead surface ECG was recorded simultaneously. Endocardial atrial activation time was measured off-line (stimulus - last bipolar recording), and the respective PWD was assessed using the root mean square and 65-channel summary plots. PWD during pacing from BB was significantly shorter (96 +/- 12 msec) than during HRA (121 +/- 15 msec), CSos (108 +/- 9 msec), and CSd pacing (126 +/- 14 msec; P < 0,01, respectively). PWD during dual-site pacing (HRA+BB, 91 +/- 14 msec; HRA+CSos, 96 +/- 7 msec; HRA+CSd, 90 +/- 7 msec; BB+CSd, 96 +/- 12 msec) was not significantly shorter than during pacing from BB. Correlation between endocardial atrial activation time and PWD was 0.83. CONCLUSION:PWD during single-site and dual-site atrial pacing represents endocardial atrial activation time and can be measured precisely using the 65-lead surface ECG. The fact that high septal pacing results in the shortest PWD may have implications for preventive pacing in patients with atrial fibrillation.

authors

Gozolits S,Fischer G,Berger T,Hanser F,Abou-Harb M,Tilg B,Pachinger O,Hintringer F,Roithinger FX

doi

10.1046/j.1540-8167.2002.01240.x

keywords:

subject

Has Abstract

pub_date

2002-12-01 00:00:00

pages

1240-5

issue

12

eissn

1045-3873

issn

1540-8167

journal_volume

13

pub_type

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