Use Of P Wave Configuration During Focalatrial Tachycardia To Predict Site Of Origin

Objective:The purpose of this study was to analyze the P'wave configuration during focal atrial tachycardia in order to explore its predictive value to the site of origin.Methods:A retrospective analysis of the P'wave characteristics of configuration during the surface electrocardiogram and the origin of the electrophysiologic study were performed.The P'wave characteristics of configuration were recorded by positive?+?,negative?-?,first positive and then turn to negative?+-?,first negative and then turn to positive?-+?,isoelectric?iso?.Results:Of the 57 patients,21 males and 36 females,mean age46.25±18.44 years and a symptom course of 41.83±48.24 months.A total of 7patients had a left ventricular ejection fraction?LVEF?<50%,of which 6 sites of origin were located in the pulmonary vein,atrial appendage,and tricuspid annulus.A total of 60 origins were detected,45 located in the right atrium?75%?and 15 located in the left atrium?25%?.The specificity to the predicted right atrial tachycardia by forward P'wave in lead avL and negative P'wave in lead V₁ was 86.7%and 93.3%,respectively,but the sensitivity was only 71.1%and33.3%.The specificity to the predicted leftfocal atrial tachycardia bythe negativeP'wave in the leads I and avL were 95.6%and 93.3%,respectively,but the sensitivity was only 33.3%and 60%.In the right atrial focal atrial tachycardia,the specificity to predicteinterval side by negative P'wave in lead I and positive P'wave in lead avR was 100%and 84.6%,respectively,but the sensitivity was 42.1%and 73.7%,respectively.Conclusions:According to the surface morphological characteristics of the surface electrocardiogram,the origin of the atrial tachycardia can be judged,and the success rate of the radiofrequency treatment of the catheter can be improved.safety.