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Human atrial repolarization: effects of sinus rate, pacing and drugs on the surface electrocardiogram

Nadia M. G. Debbas, MD, PhD, FESC, FACC^a, Steve H. D. Jackson, MD, Daniel de Jonghe, MD^a, Annie Robert and A. John Camm, MD, PhD, FESC, FACC

^a Department of Cardiology, Cliniques Universitaires St Luc, UCL, Brussels, Belgium
Department of Epidemiology, Cliniques Universitaires St Luc, UCL, Brussels, Belgium
Department of Cardiological Sciences, St George’s Hospital Medical School, London, England, United Kingdom

View larger version (13K): [in a new window]   Figure 1 Lead I of the surface electrocardiogram as recorded (top panel), with further amplification (middle panel) and with further amplification and filtration (bottom panel).

View larger version (16K): [in a new window]   Figure 2 Correlation between PTa and atrial paced cycle length (PP) in 20 patients (n = 103 points); rho = 0.76, p < 0.001, slope = 0.24, intercept = 243 ms.

View larger version (14K): [in a new window]   Figure 3 Correlation between Ta and atrial paced cycle length (PP) in 20 patients (n = 103 points); rho = 0.62, p < 0.001, slope = 0.24, intercept = 124 ms.

View larger version (14K): [in a new window]   Figure 4 Correlation between P and atrial paced cycle length (PP) in 20 patients (n = 103 points); rho = 0, p = NS.

View larger version (20K): [in a new window]   Figure 5 Effect of intravenous propranolol (0.1 mg/kg) on the atrial surface electrocardiogram. Before propranolol: P = 106 ms, Ta = 289 ms. On propranolol: P = 102 ms, Ta = 319 ms. C = corrected.

View larger version (33K): [in a new window]   Figure 6 Effect of propranolol, atropine, disopyramide and flecainide on the atrial cycle length (PP).

View larger version (16K): [in a new window]   Figure 7 Effect of propranolol, atropine, disopyramide and flecainide on the atrial surface electrocardiographic intervals, PTa, P and Ta.

View larger version (29K): [in a new window]   Figure 8 Effect of propranolol, atropine, disopyramide and flecainide on the PTa interval corrected for rate using the linear regression equation (top panel) and Bazett’s hyperbolic formula adapted to the atrium (bottom panel).