Korean Circ J.  2007 Dec;37(12):656-662. 10.4070/kcj.2007.37.12.656.

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

• Heo JH
• Yang SW
• Shin JG
• Kim SJ
• Kim OK
• Lee JH
• Choi BJ
• Cha TJ
• Lee JW

• KMID: 2227042
• DOI: http://doi.org/10.4070/kcj.2007.37.12.656

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 micron V in women and 4.5 micron V 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.

Keyword

Atrial fibrillation; Body surface area; Electrocardiography

MeSH Terms

Arrhythmias, Cardiac
Atrial Fibrillation*
Body Surface Area
Electrocardiography*
Female
Humans
Incidence
Male

Figure

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  Fig. 1 An example of a signal-averaged P wave ECG (↔: P wave duration). ECG: electrocardiogram.

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  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.

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  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.

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