Atrial Conduction and P-wave Characteristics: From histology to electrophysiology

Abstract: P-wave morphology reflects the projection of the depolarization vector on the electrocardiogram (ECG)lead axes in three-dimentional space and reflects both right and left atrial activation. The main purpose of current thesis was to explore the internal logic between the atrial conduction properties, including intra- and inter- atrial conduction, and P-wave characteristics from the level of histology to electrophysiology. The current thesis consists of four substudies entitled as: (1) P-wave characteristics and histological atrial abnormalities; (2) Effects of baseline P-wave duration and choice of atrial septal pacing site on shortening atrial activation time during pacing; (3) Diagnosis of atrial tachycardia originating from the lower right atrium: importance of P-wave morphology in the precordial leads V3-V6; and (4) Variability of P-wave morphology predicts the outcome of circumferential pulmonary vein isolation in patients with recurrent atrial fibrillation, respectively.