The Interval during Atrial Fibrillation Changes P Wave Morphology and Atrial Size

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Purpose: We attempt to assess the correlation between filtered P wave duration of signal averaged electrocardiogram (SAECG) and LA size in patients with atrial fibrillation (AF). Methods: Twenty patients with paroxysmal AF (PAF, 66±7 years old, male 8) and 6 patients with persistent AF (67±11 years old, male 4) were enrolled this study. Fifteen of these patients were received medical therapy (β blocker and/or antiarrhythmic drug). All subjects examined signal averaged electrocardiogram (ECG), echo-cardiography and computed tomography (CT). Results: The 2-dimensional left atrial area measured by echo-cardiography (LA area) in persistent AF was larger than PAF group (25.6±2.9 vs 20.4±3.4 cm2, P<0.05). The 3-dimensional LA volume measured by CT (LA volume) was not significant difference between two groups. Filtered P duration and the root mean square voltage of the terminal 20 ms (RMS20) measured by SAECG in persistent AF were significant longer and lower than PAF group (147±6.8 vs 134±13.4 ms, 2.3±0.3 vs 3.2±1.0 µV, P<0.05 respectively). Conclusions: Filtered P duration, RMS20 and LA area were significant difference between persistent and PAF. This study demonstrates that interval during AF occur mechanical and electrical change.