CineECG provides a novel anatomical view on the normal atrial P-wave

Author:

Locati Emanuela T1ORCID,Pappone Carlo12ORCID,Heilbron Francesca3ORCID,van Dam Peter M4ORCID

Affiliation:

1. Department of Arrhythmology and Electrophysiology, IRCCS Policlinico San Donato , Milano , Italy

2. University San Raffaele Vita & Salute , Milano , Italy

3. IRCCS Istituto Auxologico, University of Milan , Milan , Italy

4. Department of Cardiology, University Medical Center Utrecht , Heidelberglaan 100 , Utrecht, The Netherlands

Abstract

Abstract Aims Novel CineECG computed from standard 12-lead electrocardiogram (ECG) correlated the ventricular electric activity to ventricular anatomy. CineECG was never applied to reconstruct the spatial distribution of normal atrial electric activity into an atrial anatomic model. Methods and results From 6409 normal ECGs from PTB-XL database, we computed a median beat with fiducial points for P-and Q-onset. To determine the temporo-spatial location of atrial activity during PQ-interval, CineECG was computed on a normal 58-year-old male atrial/torso model. CineECG was projected to three major cardiac axes: posterior-anterior, right-left, base-roof, and to the standard cardiac four-chamber, left anterior oblique, and right anterior oblique (RAO) views. In 6409 normal subjects, during P-wave, CineECG moved homogeneously from right atrial roof towards left atrial base (−54 ± 14° in four-chamber view, 95 ± 24° RAO view). During terminal PQ-interval, the CineECG direction was opposite, moving towards left atrial roof (62 ± 27° in four-chamber view, 78 ± 27° RAO view). We identified the deflection point, where the atrial CineECG changes in direction. The time from P-onset to deflection point was similar to P-wave duration. Conclusion CineECG provided a novel three-dimensional visualization of atrial electrical activity during the PQ-interval, relating atrial electrical activity to the atrial anatomy. CineECG location during P-wave and terminal PQ-interval were homogeneous within normal controls. CineECG and its deflection point may enable the early detection of atrial conduction disorders predisposing to atrial arrhythmias.

Funder

Dutch Heart Foundation

Publisher

Oxford University Press (OUP)

Subject

Energy Engineering and Power Technology,Fuel Technology

Reference30 articles.

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