Alexander et al reported the Morphology-Voltage-P-Wave Duration ECG risk score for predicting the risk of atrial fibrillation for a patient. The authors are from Queen's University (Kingston) and multiple hospitals in Spain.
Patient selection: mean age 65 years
Parameters:
(1) P wave morphology in the inferior leads (reflecting interatrial block)
(2) P wave voltage in lead I
(3) P wave duration
Parameter
Finding
Points
morphology inferior leads
nonbiphasic and < 120 ms
0
nonbiphasic and >= 120 ms
1
biphasic
2
voltage in lead I
> 0.20 mV
0
0.10 to 0.20 mV
1
< 0.10 mV
2
P-wave duration
< 120 milliseconds
0
120 to 140 milliseconds
1
> 140 milliseconds
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk of atrial fibrillation.
Total Score
Probability of AF
0 to 2
low
3 or 4
intermediate
5 or 6
high
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