Signal averaged P wave compared with standard electrocardiography or echocardiography for prediction of atrial fibrillation after coronary bypass grafting

P. J. Stafford, S. Kolvekar, J. Cooper, J. Fothergill, F. Schlindwein, D. P. deBono, T. J. Spyt, C. J. Garratt
1997 Heart  
Objective-To define the clinical value of the signal averaged P wave (SAPW) and to compare it with the standard electrocardiogram (ECG), echocardiogram, and clinical assessment for the prediction of atrial fibrillation after coronary bypass grafting (CABG). Design-Prospective validation cohort study. Setting-Regional cardiothoracic centre. Patients-201 unselected patients undergoing first elective CABG were recruited over six months. Patients requiring concomitant valve surgery were excluded.
more » ... in outcome measures-Age, sex, cardiothoracic ratio, and cardioactive drugs were noted. P wave specific SAPW recordings, ECG, and M mode echocardiograms from which left atrial diameter was measured were performed within 24 hours of surgery. Filtered P wave duration (SAPWD), spatial velocity, and energy were calculated from the SAPW. From the ECG, lead II P wave duration, P terminal force in lead Vl, total P wave duration, and isoelectric interval were measured. Patients had Holter monitoring for 48 hours postoperatively and daily ECGs until discharge.
doi:10.1136/hrt.77.5.417 pmid:9196410 pmcid:PMC484762 fatcat:xcvge6yzsjaelm3him6nsppzza