New electrocardiographic parameters and risk of atrial arrhythmias in INOCA patients

Aims: Ischemia with no obstructive arteries (INOCA) is a clinical condition in which symptoms and signs of coronary artery disease are present, but coronary angiography does not show severe vessel narrowing. Atrial fibrillation (AF) is a common arrhythmia in cardiology practice, with an increasing prevalence with age and concomitant heart disease. P-wave dispersion (PWD) is an electrocardiographic (ECG) parameter defined as the difference between the maximum and minimum P-wave duration. There is an increasing number of studies showing an association between PWD and cardiovascular events. In this study, we aimed to evaluate the risk of AF in INOCA patients by detecting PWD, a new ECG parameter. Methods: The study included 51 INOCA patients and 36 healthy subjects as a control group. The groups were compared in terms of demographic characteristics, laboratory findings, echocardiography, and ECG findings. The difference between the longest P wave (Pmax) and the shortest P wave (Pmin) was considered as PWD (PWD=Pmax-Pmin). Results: When the patient group was compared with the control group, no difference was detected in terms of demographic characteristics or laboratory findings. When compared with the control group, Pmax duration and Pd values were significantly longer in the patient group compared to the control group (Pmax durations 112.7±7.09 ms and 98.1±5.5 ms, respectively, p<0.001; Pd durations 43.0±9.4 ms and 31.4±12.4 ms, respectively, p<0.001). On the other hand, Pmin durations did not differ significantly between the groups (p>0.05). Conclusion: We observed that PWD was higher in INOCA patients compared to controls, and our results suggest that INOCA patients are at risk for AF.