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- Title
Does Atrial Fibrillation Cause False-Positive Late Potentials?
- Authors
Buckingham, Thomas A.; Radin, Michael M.; Volgman, Annabelle S.; Jhangiani, Anil; Zbilut, Joseph
- Abstract
We hypothesized that atrial fibrillation may cause false-positive late potentials due to the recording of baseline atrial activity. We performed signal-averaged ECGs in 26 patients with atrial fibrillation before and after conversion to normal sinus rhythm. Signal-averaged ECGs were recorded for > 200 cycles with a noise level of < 0.5 µV. The signals were band-pass filtered at 40-250 Hz. We examined filtered QRS duration (fQRS), duration of low amplitude signal ⩽ 40 µV (LAS), and the root mean square (RMS) of the terminal 40 msec of the QRS complex. A late potential was considered present when two of the following three criteria were met: fQRS ⩾ 114 msec, LAS ⩾ 38 msec, and RMS ⩽ 20 µV. The mean ± standard deviation of the fQRS in atrial fibrillation and sinus rhythm were 313 ± 28 and 110 ± 25 msec; of the LAS 38 ± 17 and 37 ± 15 msec; of the RMS 27 ± 22 and 28 ± 21 µV; of the noise 0.25 ± 0.08 and 0.22 ± 0.07 µV (P = NS). Ten signal-averaged ECGs in atrial fibrillation had late potentials. With reversion to sinus rhythm one of these 26 patients gained a late potential; two others lost a late potential (P = NS by McNemar's Chi-square). There was no significant difference in the signal-averaged ECG parameters or noise levels. In conclusion, signal-averaged ECG parameters are not significantly changed by cardioversion of atrial fibrillation to normal sinus rhythm. Moreover, the presence of a late potential in a patient with atrial fibrillation does not appear to be the result of a spurious recording of baseline atrial fibrillatory activity.
- Subjects
ATRIAL fibrillation; HEART atrium; ELECTROCARDIOGRAPHY; CARDIAC pacing; HEART disease diagnosis
- Publication
Pacing & Clinical Electrophysiology, 1993, Vol 16, Issue 12, p2222
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.1993.tb02327.x