P Wave Dispersion: A Valuable Electrocardiographic Marker for the Prediction of Paroxysmal Lone Atrial Fibrillation

Background: The prolongation of atrial conduction time and the inhomogeneous propagation of sinus impulses are well known electrophysiological characteristics in patients with paroxysmal atrial fibrillation. Methods: The aim of this study was to test the ability of a new ECG marker to discriminate between patients with a prior history of paroxysmal lone atrial fibrillation and healthy controls. Maximum P wave duration (Pmax) and the difference between the maximum and the minimum P wave duration, which was defined as P‐wave dispersion (Pdisp) were calculated from the 12‐lead surface ECGs of 75 patients with a history of paroxysmal lone atrial fibrillation and 50 age‐matched healthy controls. Results: Pmax was in patients 122 ± 17 ms and in controls 101 ± 10 ms (t = 7.935, P > 0.001). Pdisp was in patients 48 ± 16 ms and in controls 29 ± 8 ms (t = 7.616, P > 0.001). A Pmax value of 110 ms separated patients from controls with a sensitivity 85%, a specificity 72%, and a positive predictive accuracy of 82%. A Pdisp value of 40 ms separated patients from controls with a sensitivity of 81%, a specificity of 80%, and a positive predictive accuracy of 85%. Conclusions: (1) Pmax and Pdisp values were found to be significantly higher in patients with a prior history of paroxysmal lone atrial fibrillation than in age‐matched healthy controls, and (2) Pdisp is a new simple ECG marker that could be possibly used for the identification of patients with a previous history of paroxysmal lone atrial fibrillation. A.N.E. 1999;4(1):39–45