1. The P wave dispersion—one pixel, one millisecond
- Author
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Jacek Gajek, Agnieszka Sławuta, Peter-Stephan Wolff, Jadwiga Radziejewska, Grzegorz Zawadzki, and Jacek Zawadzki
- Subjects
Electrocardiography ,Risk Factors ,RC666-701 ,Atrial Fibrillation ,p wave duration ,Humans ,Diseases of the circulatory (Cardiovascular) system ,total atrial activation time ,General Medicine ,Middle Aged ,p wave dispersion ,Cardiology and Cardiovascular Medicine ,Aged - Abstract
The electrophysiological activity of the heart is recorded and presented in form of electrocardiogram (ECG). In 1998 the concept of P wave dispersion as the risk factor for atrial fibrillation (AF) recurrence was introduced. It was calculated as the difference between the longest and the shortest P wave. The aim of our study is to prove that the P wave dispersion is an artifact of low accuracy in P wave measurement. The study included 186 patients (78M 108F) aged 59.7 ± 12.9 years, undergoing various electrophysiological procedures. The P wave was measured twice: first, at the paper speed of 50 mm/s, enhancement 8× (standard – imprecise) and the second time at 200 mm/s, 64–256× (precise). The imprecise measurement method resulted in different duration of all P wave parameters in comparison with precise measurement. The difference between Δ P max and Δ P min indicated a higher value for the latter parameter. It was indicated that the imprecise P wave dispersion value correlated most significantly with the maximal P wave duration, which was measured in a similar way. In contrast with the imprecise measurement method, the minimal and maximal durations of the P waves, being measured accurately, were almost identical. Using precise methodology, the P wave dispersion reaches negligible values and tends to zero. The measurements of the P wave have to be precise to assure the highest scientific and medical sincerity. The highest clinical value is related to the P wave duration.
- Published
- 2021
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