Signal-averaged electrocardiograms in patients with atrial fibrillation or flutter

Toby R. Engel, Nancy Vallone, John Windle

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


The signal-averaged QRS complex that is prolonged because of low amplitude late potentials predicts ventricular tachycardia. This study investigated if signal-averaged low amplitude atrial potentials predict atrial fibrillation or flutter (AFF). Low amplitude potentials were considered to be high-frequency, high amplitude P (HiFP) duration recorded between 50 and 250 Hz at 1.0 mm/μV amplitude minus unfiltered P (UnFP) duration at 0.1 mm/μV. In nine normals, HiFP averaged 115.6 msec ± 9.8 SD. HiFP were wider in 26 control patients (133.5 msec ± 15.7, p < 0.005) but HiFP-UnFP (11.2 msec ± 8.5) and signals < 10 μV terminating HiFP inscription (21.7 msec ± 23.4) were similar to normal values. Seventeen patients with paroxysmal or recently cardioverted AFF did not have significantly longer intervals than controls (HiFP averaged 138.8 msec ± 23.0, HiFP-UnFP 13.2 msec ± 9.3, and signals < 10 μV 32.4 msec ± 19.5). Therefore, signal-averaged P waves do not identify patients with AFF.

Original languageEnglish (US)
Pages (from-to)592-597
Number of pages6
JournalAmerican Heart Journal
Issue number3
StatePublished - Mar 1988

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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