November 1, 2000Pacing and Clinical Electrophysiology
P Wave Dispersion in Hypertensive Patients with Paroxysmal Atrial Fibrillation
Why the study?
Does P wave dispersion identify hypertensive patients at risk of developing paroxysmal atrial fibrillation?
Population
94 hypertensive patients, including 44 with a history of paroxysmal atrial fibrillation and 50 without a…
Comparison
Measurement of P wave dispersion from 12-lead… vs Hypertensive patients without a history of…
Design
Case-control
Authors
Discussion
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Implication
P wave dispersion may identify hypertensive patients at PAF risk; hypothesis-generating and requires prospective validation.
Key Points
- To determine whether P wave dispersion measured on surface electrocardiograms during sinus rhythm can identify hypertensive patients at increased risk of paroxysmal atrial fibrillation.
- Evaluated 12-lead surface electrocardiograms and echocardiography in 44 hypertensive patients with a history of paroxysmal atrial fibrillation (mean age 60) and 50 hypertensive controls without atrial fibrillation (mean age 57).
- Calculated maximum P wave duration, minimum P wave duration, and P wave dispersion (maximum minus minimum duration) alongside left atrial dimension and left ventricular ejection fraction.
- P wave dispersion was significantly higher in patients with paroxysmal atrial fibrillation than in controls (50 ± 12 ms vs 38 ± 8 ms, P = 0.001), while minimum P wave duration (75 ± 13 ms vs 87 ± 11 ms, P = 0.001) and left ventricular ejection fraction (0.63 ± 0.05 vs 0.67 ± 0.04, P = 0.03) were significantly lower.
- Multivariate regression revealed P wave dispersion as the only significant independent predictor of paroxysmal atrial fibrillation, whereas maximum P wave duration and left atrial dimension showed no significant differences (P > 0.05).
Structured PICO
Does P wave dispersion identify hypertensive patients at risk of developing paroxysmal atrial fibrillation?
P
Population
94 hypertensive patients, including 44 with a history of paroxysmal atrial fibrillation (PAF) (mean age 60) and 50 without a history of AF (mean age 57).
I
Intervention
Measurement of P wave dispersion from 12-lead surface electrocardiograms during sinus rhythm.
C
Comparator
Hypertensive patients without a history of atrial fibrillation.
O
Outcome
P wave dispersion (Pd = Pmax - Pmin)surrogate
P wave dispersion measured during sinus rhythm is a useful noninvasive predictor of paroxysmal atrial fibrillation in hypertensive patients.
Cite This Study
AYTEMIR et al. (2000) studied this question.