P-wave complexity in normal subjects and computer models

Mark Potse*, Theo A. R. Lankveld, Stef Zeemering, Pieter C. Dagnelie, Coen D. A. Stehouwer, Ronald M. Henry, Andre C. Linnenbank, Nico H. L. Kuijpers, Ulrich Schotten

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: P waves reported in electrocardiology literature uniformly appear smooth. Computer simulation and signal analysis studies have shown much more complex shapes. Objective: We systematically investigated P-wave complexity in normal volunteers using high-fidelity electrocardiographic techniques without filtering. Methods: We recorded 5-min multichannel ECGs in 16 healthy volunteers. Noise and interference were reduced by averaging over 300 beats per recording. In addition, normal P waves were simulated with a realistic model of the human atria. Results: Measured P waves had an average of 4.1 peaks (range 1-10) that were reproducible between recordings. Simulated P waves demonstrated similar complexity, which was related to structural discontinuities in the computer model of the atria. Conclusion: The true shape of the P wave is very irregular and is best seen in ECGs averaged over many beats.
Original languageEnglish
Pages (from-to)545-553
JournalJournal of Electrocardiology
Issue number4
Publication statusPublished - 2016


  • Electrocardiogram
  • P wave
  • Interatrial block
  • Filtering
  • Recording techniques
  • Computer models

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