Orthogonal P-wave morphology is affected by intra-atrial pressures

BMC Cardiovascular Disorders

Research Article

Jonas Carlson¹  Richard Petersson¹  Pyotr Platonov²  Fredrik Holmqvist²  J. Gustav Smith³  Öyvind Reitan³  David A. Larsson⁴ 

[1] Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden;Center for Integrative Electrocardiology, Lund University, Lund, Sweden;Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden;Center for Integrative Electrocardiology, Lund University, Lund, Sweden;Arrhythmia Clinic, Skåne University Hospital, Lund, Sweden;Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden;Heart Failure and Valvular Disease Clinic, Skåne University Hospital, Lund, Sweden;Department of Internal and Emergency Medicine, Skåne University Hospital, Lund, Sweden;

关键词: P-wave morphology;    Atrial electrophysiology;    Electrocardiography;    Pressure;    Right heart catheterization;    Echocardiography;   

DOI  :  10.1186/s12872-017-0724-x

 received in 2017-06-15, accepted in 2017-11-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIt has previously been shown that the morphology of the P-wave neither depends on atrial size in healthy subjects with physiologically enlarged atria nor on the physiological anatomical variation in transverse orientation of the left atrium. The present study aimed to investigate if different pressures in the left and right atrium are associated with different P-wave morphologies.Methods38 patients with isolated, increased left atrial pressure, 51 patients with isolated, increased right atrial pressure and 76 patients with biatrially increased pressure were studied. All had undergone right heart catheterization and had 12-lead electrocardiographic recordings, which were transformed into vectorcardiograms for detailed P-wave morphology analysis.ResultsNormal P-wave morphology (type 1) was more common in patients with isolated increased pressure in the right atrium while abnormal P-wave morphology (type 2) was more common in the groups with increased left atrial pressure (P = 0.032). Moreover, patients with increased left atrial pressure, either isolated or in conjunction with increased right atrial pressure, had significantly more often a P-wave morphology with a positive deflection in the sagittal plane (P = 0.004).ConclusionIsolated elevated right atrial pressure was associated with normal P-wave morphology while left-sided atrial pressure elevation, either isolated or in combination with right atrial pressure elevation, was associated with abnormal P-wave morphology.

【 授权许可】

CC BY   
© The Author(s). 2017