Supported in part by grants from the ‘Alexander S. Onassis’ Public Benefit Foundation, Athens, Greece, and the Wellcome Trust, London, England.
Comparison of Different Methods for Manual P Wave Duration Measurement in 12-Lead Electrocardiograms
Article first published online: 30 JUN 2006
Pacing and Clinical Electrophysiology
Volume 22, Issue 10, pages 1532–1538, October 1999
How to Cite
DILAVERIS, P., BATCHVAROV, V., GIALAFOS, J. and MALIK, M. (1999), Comparison of Different Methods for Manual P Wave Duration Measurement in 12-Lead Electrocardiograms. Pacing and Clinical Electrophysiology, 22: 1532–1538. doi: 10.1111/j.1540-8159.1999.tb00358.x
- Issue published online: 30 JUN 2006
- Article first published online: 30 JUN 2006
- Received June 15, 1999; accepted June 17, 1999.
- electrocardiographic measurements;
- P wave duration;
- P wave dispersion;
- intraobserver and interobserver errors
To determine whether different methods for the manual measurement of P wave duration are mutually consistent, we evaluated the intraobserver and interobserver errors of P wave measurements obtained in three different ways: (1) by cursor on a high resolution computer screen (on screen), (2) by calipers and a magnifying glass (on paper), and (3) by a high resolution digitizing board (on board). The agreement between the methods was assessed in 30 normal subjects and 30 patients with a history of atrial fibrillation. The maximum P wave duration (P maximum), the minimum P wave duration (P minimum), mean P wave duration (P mean), P wave dispersion (P dispersion = P maximum - P minimum), and the standard deviation of the P wave duration in all measured leads (P SD) were calculated from a 12-lead electrocardiogram in each subject. Only P maximum, P mean, and P dispersion were significantly higher in patients than in controls with all three methods. Intraobserver and interobserver relative errors were significantly different among the three methods; the lowest errors were associated with the on-screen measurement. The agreement between the three different methods was acceptable for P maximum, P mean, and P SD and rather poor for P minimum and P dispersion in both groups. The differences of the measurement by different methods did not consistently differ between the two groups. Hence, the on-screen measurements are consistent with other manual methods and provide more stable results. Manual measurement of ECG patterns should be preferably performed with digital ECG recordings displayed on a high resolution computer screen.