P2890P wave dispersion is superior to atrial dimension in predicting atrial high rate events. Results from a population of dual-chamber device recipients

Background: P wave dispersion (PWD) has been associated with the occurrence of atrial fibrillation. Objective of the study was to assess the predictive value of PWD in an heterogeneous population of ICD recipients in order to detect silent atrial high rate episodes (AHRE). Methods: Sixty-six patients implanted with a dual-chamber ICD for any reason were retrospectively analyzed. All patients were in sinus rhythm at enrollment. Basal ECG at the time of implant was used. Device follow-up was analyzed to detect any AHRE. Results: Characteristics of the population are summarized in Table 1. Median follow-up was 3.3 [2.9–3.5] years. Reason for implant was primary prevention in 53% of patients. Underlying heart disease was structural heart disease in 49 pts and arrhythmic cardiopathy in 17 cases. AHRE occurred in 20 cases (30.3%). PWD is significantly higher in patients with AHRE at follow-up (50.3±21.1 ms vs. 28.1±9.6 ms; p<0.001). At the multivariate analysis PWD is independently associated with AHRE (OR:1.14 [1.04–1.23]; p=0.003) if considered with left atrial (LA) dimension and age. PWD was higher for any degree of LA enlargement (Figure 1).