Short-term repeatability of electrocardiographic P wave indices and PR interval

J Electrocardiol. 2014 Mar-Apr;47(2):257-63. doi: 10.1016/j.jelectrocard.2013.11.007. Epub 2013 Nov 25.

Abstract

Background: P wave indices and PR interval from 12-lead electrocardiograms (ECGs) are predictors of cardiovascular morbidity and mortality, but their repeatability has not been examined.

Objectives: Determine the short-term repeatability of P wave indices (P axis, maximum P area and duration, P dispersion and P terminal force in V1) and PR interval.

Methods: Participants (n=63) underwent two standard ECGs at each of two visits, two weeks apart. We calculated the intra-class correlation coefficient (ICC), weighted kappa, and minimal detectable change and difference.

Results: ICCs were 0.93 for PR interval, 0.78 for P axis, 0.77 for maximum P area, and 0.58 for maximum P duration. Within- and between-visit Kappa were 0.30 and 0.11 for P dispersion, and 0.68 and 0.46 for P terminal force.

Conclusion: Repeatability of PR duration was excellent, that of P wave axis and maximum area was fair, and maximum P wave duration and terminal force was poor. Repeatability of P wave dispersion was fair within visit, yet poor between visits. These results illustrate potential biases when measurement error of some P wave indices is ignored in clinical and epidemiologic studies.

Keywords: P wave indices; PR interval; Reliability; Repeatability.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / physiopathology*
  • Electrocardiography / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Signal Processing, Computer-Assisted