{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:38:21Z","timestamp":1786977501975,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2007,7,5]],"date-time":"2007-07-05T00:00:00Z","timestamp":1183593600000},"content-version":"vor","delay-in-days":1707,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2002,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Background<\/jats:italic>\n                    : Atrial fibrillation is often first recognized after a complication such as embolic stroke has occurred. Limited data are available for the prospective identification of patients at risk for developing atrial fibrillation.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Hypothesis<\/jats:italic>\n                    : Demonstration of areas of slow conduction in the atrium by means of P\u2010wave signal averaging may identify individuals at risk for atrial fibrillation.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Methods<\/jats:italic>\n                    : P\u2010wave signal averaging from the surface electrocardiogram was performed in 199 normal controls and 81 patients with paroxysmal atrial fibrillation using an automated, P\u2010triggered, high\u2010resolution signal for analysis.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Results<\/jats:italic>\n                    : Of the variables measured, the filtered P\u2010wave duration and P\u2010wave integral were significantly different between controls and patients (filtered P\u2010wave duration 120 \u00b1 9 vs. 145 \u00b1 21 and P\u2010wave integral 666 \u00b1 208 vs. 868 \u00b1 352), whereas the terminal root\u2010mean\u2010square (RMS) voltages (RMS 20, RMS 30, RMS 40) showed no significant differences between the two groups. Regression analysis of the first and second measurement of the filtered P\u2010wave duration obtained during consecutive tests showed excellent reproducibility (r and r\n                    <jats:sup>2<\/jats:sup>\n                    of 0.96 and 0.92). The duration of the filtered P wave showed no age dependence but was shorter in women.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusion<\/jats:italic>\n                    : Utilizing the 90th percentile value of the filtered P\u2010wave duration of 13 3 ms in men and 13 0 ms in women, the sensitivity was 80 and 81%, the specificity 92 and 90%, the positive predictive value 84 and 73%, and the negative predictive value 90 and 93%, respectively.\n                  <\/jats:p>","DOI":"10.1002\/clc.4960251109","type":"journal-article","created":{"date-parts":[[2009,7,16]],"date-time":"2009-07-16T03:28:23Z","timestamp":1247714903000},"page":"525-531","source":"Crossref","is-referenced-by-count":39,"title":["Signal\u2010Averaged P\u2010Wave Analysis of Normal Controls and Patients with Paroxysmal Atrial Fibrillation: A Study in Gender Differences, Age Dependence, and Reproducibility"],"prefix":"10.1002","volume":"25","author":[{"given":"Anwer","family":"Dhala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Underwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Leman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Madu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dainia","family":"Baugh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukio","family":"Ozawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Kasamaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuzhen","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shankara","family":"Reddy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,7,5]]},"reference":[{"key":"e_1_2_1_2_2","first-page":"2606","article-title":"Detection of patients at risk for paroxysmal atrial fibrillation during sinus rhythm by P\u2010wave\u2010triggered signal averaged electrocardiogram","volume":"84","author":"Fukunami M","year":"1991","journal-title":"Circulation"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5273(91)90009-E"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(91)90648-5"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90381-A"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1994.tb01469.x"},{"key":"e_1_2_1_7_2","doi-asserted-by":"crossref","unstructured":"StaffordPJ RobinsonD VincentR: Optimal analysis of the signal averaged P wave in patients with paroxysmal atrial fibrillation.Br Heart J1995;413\u2013418","DOI":"10.1136\/hrt.74.4.413"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)80540-2"},{"key":"e_1_2_1_9_2","first-page":"139","volume-title":"Electrocardiology","author":"Xue Q","year":"1996"},{"key":"e_1_2_1_10_2","first-page":"1","article-title":"P\u2010wave signal averaged ECG: New algorithms for detecting patients at risk of atrial fibrillation (abstr)","volume":"90","author":"Chauvin M","year":"1994","journal-title":"Circulation"},{"key":"e_1_2_1_11_2","first-page":"1","article-title":"Gender specific differences in the p wave signal averaged electrocardiogram (abstr)","volume":"94","author":"Dhala A","year":"1996","journal-title":"Circulation"},{"key":"e_1_2_1_12_2","first-page":"438","volume-title":"Comprehensive Electrocardiography\u2014Theory and Practice in Health and Disease","author":"MacFarlane P","year":"1989"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1996.tb04793.x"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1996.tb03255.x"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1997.tb03533.x"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.77.5.412"},{"key":"e_1_2_1_17_2","first-page":"30A","article-title":"Reproducibility and long\u2010term change of the P wave\u2010triggered signal averaged ECG (abstr)","volume":"29","author":"Yamada T","year":"1997","journal-title":"J Am Coll Cardiol"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(97)70016-4"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1998.tb00910.x"},{"key":"e_1_2_1_20_2","first-page":"278","article-title":"Evaluation of signal averaged P\u2010wave in patients with and without history of atrial arrhythmias. 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