Characteristics of the atrial repolarization phase of the ECG in paroxysmal atrial fibrillation patients and controls

Objective The aim of this study is to characterize the observable segment of the atrial repolarization (Ta wave) of the standard ECG during sinus rhythm in paroxysmal atrial fibrillation (PAF) patients and controls. Methods Ta and P waves were measured from signal-averaged recordings of a standard 12-lead ECG in 40 patients, 20 with PAF, but in SR at the time of recording, and 20 healthy controls. Wave amplitudes and morphologies were measured. Results There were no significant differences in Ta amplitude between the PAF patients and controls. A subgroup analysis of patients on and off anti-arrhythmic drugs also showed no significant differences in Ta amplitudes. For both groups Ta wave had opposite polarity to the monophasic P wave. Biphasic P waves had Ta polarity opposite to the initial phase of the P wave. Ta wave amplitudes were largest in leads II (mean +/- SD, -25 +/- 16 mu V), V2 (-22 +/- 10 mu V), V3 (-21 +/- 10 mu V) and V4 (-20 +/- 8 mu V). A significant correlation was found between Ta and P wave amplitudes, leads recording larger P waves also had larger Ta waves (PAF group: r = 0.15 (P=0.02) PAF vs r = 0.33 (P = 0.002) HC). Conclusion No differences in the amplitude of the observable section of the atrial repolarization phase of the ECG could be observed between patients with PAF and controls. Ta wave correlates with the corresponding P wave in both amplitude and polarity.