Gender Differences of P Wave Signal Averaged Electrocardiograms: Based on the Risk of Atrial Fibrillation

Jung-Ho Heo; Sung-Woo Yang; Jung-Gwang Shin; Sun-Jung Kim; O-Kil Kim; Ji-Hyun Lee; Byung-Joo Choi; Tae-Joon Cha; Jae-Woo Lee

doi:10.4070/kcj.2007.37.12.656

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Heo, Yang, Shin, Kim, Kim, Lee, Choi, Cha, and Lee: Gender Differences of P Wave Signal Averaged Electrocardiograms: Based on the Risk of Atrial Fibrillation

Original Article

Korean Circulation Journal

Korean Circulation Journal 2007; 37(12): 656-662.

Published online: 31 December 2007

DOI: https://doi.org/10.4070/kcj.2007.37.12.656

Gender Differences of P Wave Signal Averaged Electrocardiograms: Based on the Risk of Atrial Fibrillation

Jung-Ho Heo, MD, Sung-Woo Yang, MD, Jung-Gwang Shin, MD, Sun-Jung Kim, MD, O-Kil Kim, MD, Ji-Hyun Lee, MD, Byung-Joo Choi, MD, Tae-Joon Cha, MD, Jae-Woo Lee, MD

Division of Cardiology, Department of Internal Medicine, Kosin University School of Medicine, Busan, Korea.

Correspondence: Tae-Joon Cha, MD, Division of Cardiology, Department of Internal Medicine, Kosin University School of Medicine, 34 Amnam-dong, Seo-gu, Busan 602-702, Korea. Tel: 82-51-990-6105, Fax: 82-51-990-3047, chatjn@kosinmed.or.kr

Received 11 March 2007 Revised 10 September 2007 Accepted 13 September 2007

Abstract

Background and Objectives

Certain types of arrhythmias have gender differences. Women have a higher incidence of drug-induced QT prolongation than in men. However, there are no reports regarding gender-related differences of the P wave signal averaged electrocardiogram (PWSAE), based on the risk of atrial fibrillation (AF). PWSAE has been recognized as a diagnostic tool for identifying the risk of paroxysmal atrial fibrillation (PAF). We therefore investigated the influence of gender in the parameters of PWSAE and in the risk of AF.

Subjects and Methods

We recorded 100 PWSAEs in apparently healthy Korean subjects (53 men and 47 women), aged 20 to 79 years.

Results

The mean age of the male subjects was 38.2 years and the mean age of the female subjects was 43.2 years (p=0.19). The body surface area (BSA) were larger in men (1.83 m² vs. 1.53 m², p<0.05). In men, the filtered P wave duration (fPD) was longer than in women (136.8 msec vs. 125.2 msec, p<0.05). The root mean square voltage in the terminal 20 ms of the filtered P wave (RMS20) was 5.9 µV in women and 4.5 µV in men (p<0.05).

Conclusion

Men have a longer fPD and lower RMS20 than women. The BSA showed a positive correlation with fPD and a negative correlation with RMS20. This study suggests that BSA is an important factor for fPD and RMS20. In addition, as men have a larger BSA as compared with women, we suspect that men have a higher risk of AF as compared with women.

Keywords: Atrial fibrillation, Body surface area, Electrocardiography

Figures and Tables

Fig. 1

An example of a signal-averaged P wave ECG (↔: P wave duration). ECG: electrocardiogram.

Fig. 2

Correlation between age, body surface area and the filtered P-wave duration (fPD). A: there was a weak positive correlation between fPD and body surface area (r=0.260, p=0.010). B: no correlation was observed between RMS20 and age. RMS20: root mean square of the terminal 20 milliseconds.

Fig. 3

Correlation between age, body surface area and RMS20. A: there was a negative correlation between RMS20 and the body surface area (r=-0.348, p<0.001). B: no correlation was observed between RMS20 and age. RMS20: root mean square of terminal 20 milliseconds.

Table 1

Clinical characteristics of the study subjects

BSA: body surface area, SBP: systolic blood pressure, DBP: diastolic blood pressure, HR: heart rate, EF: ejection fraction, LAD: left atrial diameter, NS: not significant

Table 2

PWSAE parameters of the study subjects

PWSAE: P wave signal averaged electrocardiogram, RMS20: root mean square of the terminal 20 milliseconds, fPD: filtered P wave duration, RMS P: root mean square of the P wave, NS: not significant

Table 3

Correlation coefficients between age, BSA and P-wave SAECG parameters

BSA: body surface area, SAECG: signal averaged ECG, RMS20: root mean square of the terminal 20 milliseconds, RMS P: root mean square of the P wave, fPD: filtered P wave duration, ECG: electrocardiogram, NS: not significant

Table 4

Correlation coefficients between EF, LAD and P-wave SAECG parameters

EF: ejection fraction, LAD: left atrial diameter, SAECG: signal averaged ECG, ECG: electrocardiogram, RMS20: root mean square of terminal 20 milliseconds, RMS P: root mean square of P wave, fPD: filtered P wave duration, NS: not significant

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