P-wave complexity in normal subjects and computer models

J Electrocardiol. 2016 Jul-Aug;49(4):545-53. doi: 10.1016/j.jelectrocard.2016.05.005. Epub 2016 May 12.

Abstract

Background: P waves reported in electrocardiology literature uniformly appear smooth. Computer simulation and signal analysis studies have shown much more complex shapes.

Objective: We systematically investigated P-wave complexity in normal volunteers using high-fidelity electrocardiographic techniques without filtering.

Methods: We recorded 5-min multichannel ECGs in 16 healthy volunteers. Noise and interference were reduced by averaging over 300 beats per recording. In addition, normal P waves were simulated with a realistic model of the human atria.

Results: Measured P waves had an average of 4.1 peaks (range 1-10) that were reproducible between recordings. Simulated P waves demonstrated similar complexity, which was related to structural discontinuities in the computer model of the atria.

Conclusion: The true shape of the P wave is very irregular and is best seen in ECGs averaged over many beats.

Keywords: Computer models; Electrocardiogram; Filtering; Interatrial block; P wave; Recording techniques.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aging / physiology*
  • Computer Simulation
  • Electrocardiography / methods*
  • Female
  • Heart Atria / physiopathology*
  • Heart Conduction System / physiology*
  • Humans
  • Male
  • Middle Aged
  • Models, Cardiovascular*
  • Netherlands
  • Reference Values
  • Reproducibility of Results
  • Sensitivity and Specificity