Biphasic P Wave in Lead II Is a Novel Electrophysiologic Marker for Atrial Fibrillation

Background: Interatrial and intraartial block cause anisotropic conduction, affecting P wave morphology. This study aims at investigating whether biphasic P wave in lead II is associated with AF development.Methods: Digital analysis of 12-lead ECG was performed to enroll patients with biphasic P wave in lead II from among a database containing 308,391 ECGs. Age- and gender-matched patients served as control.Results: A total of 302 patients with biphasic P wave in lead II were chosen. Control group consisted of 1,208 patients. The incidence of AF was 8.3-fold higher than that in control patients . During follow-up , 65 case patients developed AF versus 237 case patients who did not . The area and duration of P-wave initial portion in lead II were significantly greater in AF group than in non-AF group .Conclusion: Biphasic P wave in lead II is closely associated with AF development.