Abstract
BackgroundThe criteria applied for diagnosis of left atrial (LA) abnormality using electrocardiogram (ECG) have high specificity but low sensitivity. In fact, some authors have suggested classifying P‐wave anomalies associated with LA abnormality and interatrial block as “atrial abnormalities.” The most widely known ECG criteria for LA abnormality include P‐wave duration, morphology and voltage of P wave in inferior leads, presence of P‐wave terminal force in V1 (PtfV1), and P‐wave axis and area. PtfV1 has also been reported to vary according to misplacement of the V1 and V2 electrodes.MethodsThe objective of this observational cohort study is to determine the degree of correlation between ECG criteria for LA abnormality and left atrium volume and functionality, as determined by speckle tracking echocardiography. The study also aims to investigate the correlation between these echocardiographic parameters and PtfV1 value by placing the V1 and V2 electrodes in the second, third, and fourth intercostal spaces.Results and ConclusionsOur results could help to clarify whether the decrease in left atrial deformity, which is currently considered a surrogate target of fibrosis, correlates better with ECG criteria for LA abnormality than atrial volumes.
Highlights
The criteria applied for diagnosis of left atrial (LA) abnormality using electrocardiogram (ECG) are based on various parameters including P-wave duration ≥ 120 ms, the classic Morris index
Some authors have suggested that this V1 pattern represents no more than an interatrial conduction defect and may not necessarily indicate LA abnormality (Josephson et al, 1977)
We aim to study the association between P-wave criteria in patients with left atrium (LA) functional abnormalities on speckle tracking echocardiography (STE)
Summary
The criteria applied for diagnosis of left atrial (LA) abnormality using electrocardiogram (ECG) are based on various parameters including P-wave duration ≥ 120 ms, the classic Morris index (increase in P-wave terminal force in V1 [PtfV1], with terminal negativity of P wave in V1 < −0.1 mV and duration >0.04 s) & Thompson, 1964), P-wave morphology in inferior leads, P voltage in lead I, P-wave area/axis, and P-wave score(Alexander et al, 2019). These criteria have high specificity (85%–90%) but low sensitivity (Josephson, Kastor, & Morganroth, 1977; Tsao et al, 2008; Bayes de Luna, 2012) and can be used for diagnosis of interatrial block (IAB). We will analyze the correlation between these echocardiographic parameters and PtfV1 value by placing the V1 and V2 electrodes in the second, third, and fourth intercostal spaces
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