gms | German Medical Science

33rd International Congress on Electrocardiology

International Society of Electrocardiology

Signal-averaged electrocardiography parameters identify risk and predict paroxysmal atrial fibrillation and hospitalization in patients with congestive heart failure

Meeting Abstract

  • corresponding author presenting/speaker V.V. Popov - Moscow University of Medicine and Dentistry, Moscow, Russland
  • N.A. Bulanova - Educational Research Medical Center, Moscow, Russland
  • N.P. Kopitsa - Research institute of Therapy of AMS of Ukraine, Kharkov, Ukraine
  • A.E. Radzevich - Moscow University of Medicine and Dentistry, Moscow, Russland

33rd International Congress on Electrocardiology. Cologne, 28.06.-01.07.2006. Düsseldorf, Köln: German Medical Science; 2007. Doc06ice060

The electronic version of this article is the complete one and can be found online at:

Published: February 8, 2007

© 2007 Popov et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Question: To evaluate the prognostic roles of signal-averaged electrocardiography (SAECG) parameters and clinical characteristics in patients with congestive heart failure.

Methods used: The signal-averaged P wave duration was assessed from SAECG of 70 patients with stable CHF NYHA II –III and coronary artery disease with prior paroxysmal atrial fibrillation (AF). Echocardiographic, ECG and clinical data were also recorded. Sudden cardiac death ( SCD), hospitalization due to deteriorated CHF or ECG-documented AF was defined as endpoints over a 12 month of follow-up.

Results: During follow-up 15 patients met the endpoint defined as hospitalization due to deteriorated CHF, 21 patients met the endpoint defined as AF and 3 patients met the endpoint defined as SCD. Proportional hazard regression analysis showed that only prolonged signal-averaged P wave duration more 112 ms was associated with an increased risk of paroxysmal AF. SAQRS more 104.1 ms and QTc-max more 420.0 ms ½ associated with increased risk of hospitalization due to deteriorated CHF. In case of patients who died suddenly we found increased QRS duration, ventricular late potentials in 2 cases, increased QTc and QTc-max. Conclusion: Prolonged signal-averaged P wave duration appears to predict early AF development in CHF patients. Increased SAQRS, QTc-max and QTc duration associate with increased risk of SCD and hospitalization due to deterioration of CH