Cited by 86Cardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmiasAtrial Fibrillation Management and Outcomes

Interatrial conduction can be accurately determined using standard 12-lead electrocardiography: Validation of P-wave morphology using electroanatomic mapping in man

Open access
Holmqvist, Fredrik, Husser, Daniela, Tapanainen, Jari M., Carlson, Jonas, Jurkko, Raija, Xia, Yunlong, Havmöller, Rasmus, Kongstad, Ole +3 more·2008·Heart Rhythm

Abstract

Background Different P-wave morphologies during sinus rhythm as displayed on standard ECGs have been postulated to correspond to differences in interatrial conduction.Objective The purpose of this study was to evaluate the hypothesis by comparing P-wave morphologies using left atrial activation maps.Methods Twenty-eight patients (mean age 49 +/- 9 years) admitted for ablation of paroxysmal atrial fibrillation were studied. Electroanatomic mapping of left atrial activation was performed at baseline during sinus rhythm with simultaneous recording of standard 12-lead ECG. Unfiltered signal-averaged P waves were analyzed to determine orthogonal P-wave morphology. The morphology was subsequently classified into one of three predefined types. All analyses were blinded.Results The primary left atrial breakthrough site was the fossa ovalis in 8 patients, Bachmann bundle in 18, and coronary sinus in 2. Type 1 P-wave morphology was observed in 9 patients, type 2 in 17, and type 3 in 2. Seven of eight patients with fossa ovalis breakthrough had type 1 P-wave morphology, 16 of 18 patients with Bachmann bundle breakthrough had type 2 morphology, and both patients with coronary sinus breakthrough had type 3 P-wave morphology. Overall, P-wave morphology criteria correctly identified the site of left atrial breakthrough in 25 (89%) of 28 patients.Conclusion In the vast majority of patients, P-wave morphology derived from standard 12-lead ECG can be used to correctly identify the left atrial breakthrough site and the corresponding route of interatrial conduction.

Integrity signals

Registry

Crossref · 10.1016/j.hrthm.2007.12.017

Cites

33 of 33 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Analysis of P-wave morphology derived from P wave signal averaged ECG without the commonly applied bandpass filtering enables identification of the interatrial conduction route with high accuracy.

    “Analysis of P-wave morphology derived from P wave signal averaged ECG without the commonly applied bandpass filtering, was shown to enable the identification of the interatrial conduction route with high accuracy.13”

    From The Year of 2008 in Electrocardiology (2010) · cites this paper as [13]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Holmqvist, F., Husser, D., Tapanainen, J. M., Carlson, J., Jurkko, R., Xia, Y., Havmöller, R., Kongstad, O., Toivonen, L., Olsson, S. B., & Platonov, P. G.
Affiliations
  • Lund University (SE)
  • Helsinki University Hospital (FI)
Corresponding author
Platonov, Pyotr G.
Venue
Heart Rhythm
Publisher
Elsevier BV
Published
2008-03
Volume
5
Issue
3
Pages
413-418
ISSN
1547-5271 (ISSN-L)
OpenAlex
W2025939712
Cited by
86
References
33
Citations by year
2026: 3 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 3 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 6 · 2016: 4 · 2015: 4 · 2014: 8 · 2013: 2 · 2012: 11
FWCI
4.67
Type
journal article
Language
en
Open access
Locations
  • Heart Rhythm (publishedVersion)
  • PubMed (publishedVersion)
  • Lund University Publications (Lund University) (submittedVersion, other-oa)
Funders
  • Sydäntutkimussäätiö
  • Volkswagen Foundation
  • Hjärt-Lungfonden
  • NordForsk
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Keywords
interatrial conduction, P wave morphology, electroanatomical mapping, paroxysmal atrial fibrillation, Bachmann bundle, fossa ovalis, coronary sinus, sinus rhythm, signal-averaged P wave
MeSH terms
Atrial Fibrillation, Electrocardiography, Female, Heart Conduction System, Humans, Male, Middle Aged, Electrophysiologic Techniques, Cardiac

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review