Abstract
We appreciate the insightful and clinically relevant comments of Dr Madias on our recent study.1 Dr Madias hypothesizes that prolongation of the P wave on the surface ECG, which has been epidemiologically linked with atrial fibrillation (AF),2 may complement our report1 that oscillations of atrial repolarization indicate a spectrum of AF vulnerability from control subjects without AF, through patients with paroxysmal AF to those with persistent AF. We have recently studied this issue3 by analyzing biatrial conduction in these patients to test the hypothesis that dynamic conduction slowing indicates vulnerability to AF, and may be most marked at the site of AF initiation. It is noteworthy that baseline ECG P-wave duration did not differ between control subjects and patients with …
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