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rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
1996-11-7
pubmed:abstractText
P wave morphology during atrial pacing along the atrioventricular (AV) ring was evaluated to develop electrocardiographic (ECG) criteria for identifying the site of origin of the atrial activation wave during reentrant supraventricular tachycardia. Because P wave morphology changes as the pattern of atrial activation changes, the P wave should show characteristic morphologies during reentrant supraventricular tachycardia with use of either accessory AV pathways or the AV node for retrograde atrial activation. In 14 patients, 12-lead ECGs were recorded during bipolar atrial pacing at sites in the coronary sinus vein (along the mitral annulus) and along the atrial endocardium of the tricuspid annulus. P wave morphology was graded for each lead at each site. Sensitivity, specificity, and predictive value of ECG criteria for left versus right and anterior versus posterior atrial pacing sites were evaluated. Data were obtained from 14 sites along the AV ring, including 71 recordings at 6 sites in the coronary sinus vein and 94 recordings at 8 sites along the tricuspid annulus. These recordings were further divided into 54 anterior sites and 80 posterior sites, as well as 62 recordings along the right free wall and 32 recordings along the right atrial septum. The predictive value of a positive P wave in lead I indicating right atrial site of origin was 98.9%, and that for a negative or isoelectric P wave in lead I indicating a left atrial site of origin was 94.6%. Negative P wave in leads II, III, and aVF indicated a posterior site of origin, with a predictive value of 91.2%. The predictive value of a negative or isoelectric P wave in lead V1 indicating a right atrial free wall site was 87.5%. Thus, P wave morphology can be used to localize the site of origin of the atrial depolarization wave to a region along the AV ring.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
0022-0736
pubmed:author
pubmed:issnType
Print
pubmed:volume
29
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1-10
pubmed:dateRevised
2009-11-11
pubmed:meshHeading
pubmed:year
1996
pubmed:articleTitle
P wave morphology during atrial pacing along the atrioventricular ring. ECG localization of the site of origin of retrograde atrial activation.
pubmed:affiliation
Cardiology Section, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina, 27157-1046, USA.
pubmed:publicationType
Journal Article