Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Jan;15(1):77-84.
doi: 10.1111/j.1542-474X.2009.00343.x.

P-wave indices, distribution and quality control assessment (from the Framingham Heart Study)

Jared W Magnani  1 , Michael J Mazzini, Lisa M Sullivan, MaryAnn Williamson, Patrick T Ellinor, Emelia J Benjamin
Affiliations

P-wave indices, distribution and quality control assessment (from the Framingham Heart Study)

Jared W Magnani et al. Ann Noninvasive Electrocardiol. 2010 Jan.

Abstract

Background: P-wave indices of maximum P-wave duration and P-wave dispersion have been examined in a broad array of cardiovascular and noncardiovascular disease states. The P-wave indices literature has been highly heterogeneous in measurement methodologies, described quality control metrics, and distribution of values. We therefore sought to determine the reproducibility of P-wave indices in a community-based cohort.

Methods: P-wave indices were measured in sequential subjects enrolled in the Framingham Heart Study. Electrocardiograms were obtained at the 11th biennial visit of the Original Cohort (n = 250) and the initial visit of the Offspring Cohort (n = 252). We determined the mean P-wave durations, interlead correlations, and P-wave indices. We then chose 20 ECGs, 10 from each cohort, and assessed intrarater and interrater variability.

Results: The maximum P-wave duration ranged from 71 to 162 ms with mean of 112 + or - 12 ms. The minimum P-wave duration ranged from 35 to 103 ms with mean of 65 + or - 10 ms. P-wave dispersion ranged from 12 to 82 ms. The mean P-wave dispersion was 48 + or - 12 ms (40-56). The intrarater intraclass correlation coefficient (ICC) was r = 0.80 for maximum P-wave duration and r = 0.82 for P-wave dispersion. The interrater ICC was 0.56 for maximum P-wave duration and 0.70 for P-wave dispersion.

Conclusions: We demonstrated excellent intrarater reproducibility and fair interrater reproducibility for calculating P-wave indices. Reproducibility is frequently lacking in studies of P-wave indices, but is an essential component for the field's growth and epidemiologic contribution.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Box‐and‐whisker plot demonstrating the distribution of P‐wave duration per lead in milliseconds. The middle line of the box represents the median and the top and bottom borders are the interquartile range; the mean is depicted with a + sign. The figure shows overlap of the interquartile range among all 12 leads except aVL.
See this image and copyright information in PMC

References

    1. Magnani JW, Williamson MA, Monahan KM, et al P wave indices: Current status and future directions in epidemiology, clinical and research applications. Circ Arrhythmia Electrophysiol 2009;2:72–79. - PMC - PubMed
    1. Aytemir K, Ozer N, Atalar E, et al P wave dispersion on 12‐lead electrocardiography in patients with paroxysmal atrial fibrillation. Pacing Clin Electrophysiol 2000;23:1109–1112. - PubMed
    1. Dilaveris PE, Gialafos EJ, Sideris SK, et al Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998;135:733–738. - PubMed
    1. Dilaveris PE, Gialafos JE. P‐wave dispersion: A novel predictor of paroxysmal atrial fibrillation. Ann Noninvasive Electrocardiol 2001;6:159–165. - PMC - PubMed
    1. Boriani G, Diemberger I, Biffi M, et al P wave dispersion and short‐term versus late atrial fibrillation recurrences after cardioversion. Int J Cardiol 2005;101:355–361. - PubMed

Publication types