Key result
Prolonged signal-averaged P wave duration (180 ms) was associated with an increased risk of developing permanent AF at 3 years compared to normal duration (72% vs 39%; p=0.006).
Why the study?
Does prolonged signal-averaged P wave duration predict the development of permanent AF in patients with earlier ECG-documented AF and successfully restored sinus rhythm?
Observational (n=131)
Does prolonged signal-averaged P wave duration predict the development of permanent AF in patients with earlier ECG-documented AF and successfully restored sinus rhythm?
Absolute Event Rate: 72% vs 39%
p-value: p=0.006
Prolonged signal-averaged P wave duration is a significant risk factor for the long-term development of permanent atrial fibrillation in patients with restored sinus rhythm.
May aid post-AF risk stratification; leaves open whether P-wave-guided interventions alter permanent AF incidence.
OBJECTIVE: To assess the long-term risk of developing permanent AF in relation to the signal-averaged P wave duration (SAPWD) and clinical and echocardiographic characteristics. DESIGN: In an observational study design we studied 131 patients with earlier ECG-documented AF and successfully restored sinus rhythm attending a long-term, follow-up visit at hospital or at home. Established permanent AF was examined in relation to primary clinical, echocardiographic, and electrophysiological parameters. RESULTS: Only prolonged SAPWD (p=0.006) was associated with an increased risk of development of permanent AF. The risk of permanent AF after 3 years follow-up was 0.72 with an SAPWD equal to 180 ms versus 0.39 with a normal SAPWD (130 ms). We found no prognostic effect of age, gender, dilated left atrium, long duration of AF history, or long duration of the most recent episode of AF. Co-existing hypertension reduced the risk of permanent AF; this could be explained by concomitant treatment with angiotensin-converting-enzyme-inhibitors. CONCLUSION: Prolonged SAPWD (a marker of atrial remodelling) appears to be a risk factor for long-term development of permanent AF.
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Dixen et al. (2008) conducted an observational in Atrial fibrillation (n=131). Prolonged signal-averaged P wave duration (SAPWD) vs. Normal SAPWD (130 ms) was evaluated on Development of permanent AF (p=0.006). Prolonged signal-averaged P wave duration (180 ms) was associated with an increased risk of developing permanent AF at 3 years compared to normal duration (72% vs 39%; p=0.006).
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