PMID: 9535479Apr 16, 1998Paper

Value of the signal-averaged P wave analysis in predicting atrial fibrillation after cardiac surgery

Journal of Electrocardiology
J E Tamis, J S Steinberg

Abstract

Atrial fibrillation (AF) is the most common sustained arrhythmia occurring after cardiac surgery. Beside important implications regarding patient recovery, AF has been shown to substantially lengthen hospital stay--our recent study found a 3-day prolongation after adjusting for all other significant factors. Identification of those at highest risk of AF by clinical or noninvasive characteristics may be a useful strategy for targeted prophylactic therapy. Our data have shown that prolonged atrial conduction as assessed by analysis of the P wave duration from the signal-averaged electrocardiogram (SAECG) imparts a four fold increase in risk for postoperative AF, independently of other measured variables. In addition, abnormal conduction was present on the preoperative P wave ECG (P-SAECG), implying a preexisting substrate that is triggered by surgery. The use of combination abnormal noninvasive variables (eg, abnormal P-SAECG and low left ventricular ejection fraction) can identify groups with a 50% risk of AF, which is nine times as high as when both tests are normal. Thus, the P-SAECG is a useful and accurate predictor of AF after cardiac surgery.

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Citations

Jul 1, 1999·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·R AscioneG D Angelini
Aug 9, 2002·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Paolo CaravelliMario Mariani
Oct 8, 2009·Circulation. Arrhythmia and Electrophysiology·Jared W MagnaniEmelia J Benjamin
Mar 9, 2006·Progress in Cardiovascular Nursing·Kimberly ScherrCori-Lynn Kozak
Jul 21, 2009·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Fredrik HolmqvistUNKNOWN MADIT II Investigators
Jul 21, 2009·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Rasmus HavmöllerPyotr Platonov

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