Key result
Sinus and paced P wave duration and dispersion were not predictive of atrial fibrillation after pacemaker implantation, whereas bradycardia-tachycardia syndrome was a strong predictor (P<0.001).
Why the study?
Do sinus and paced P wave duration and dispersion predict atrial fibrillation after pacemaker implantation in patients with isolated sick sinus syndrome?
Cohort (n=109)
Do sinus and paced P wave duration and dispersion predict atrial fibrillation after pacemaker implantation in patients with isolated sick sinus syndrome?
Sinus and paced P wave duration and dispersion do not predict the occurrence of atrial fibrillation after pacemaker implantation in patients with isolated sick sinus syndrome.
P-wave metrics lack predictive value for post-pacemaker AF in sick sinus syndrome; leaves open alternative markers while reinforcing bradycardia-tachycardia syndrome as dominant risk factor.
The aim of this study was to prospectively evaluate the sinus and the paced P wave duration and dispersion as predictors of AF after pacemaker implantation in patients with isolated sick sinus syndrome (SSS). The study included 109 (69 women, mean age 72 +/- 11 years) patients with SSS, 59 with bradycardia-tachycardia syndrome (BTS). A 12-lead ECG was recorded before pacemaker implantation and during high right atrial and septal right atrial pacing at 70 and 100 beats/min. The ECGs were scanned into a computer and analyzed on screen. The patients were treated with AAIR (n = 52) or DDDR pacing. The P wave duration was measured in each lead and mean P wave duration and P wave dispersion were calculated for each ECG. AF during follow-up was defined as: AF in an ECG at or between follow-up visits; an atrial high rate episode with a rate of > or =220 beats/min for > or =5 minutes, atrial sensing with a rate of > or =170 beats/min in > or =5% of total counted beats, mode-switching in >/=5% of total time recorded, or a mode switching episode of > or =5 minutes recorded by the pacemaker telemetry. The ECG parameters were correlated to AF during follow-up. Mean follow-up was 1.5 +/- 0.9 years. None of the ECG parameters differed between patients with AF and patients without AF during follow-up, nor was there any difference between groups after correction for BTS and age. BTS was the strongest predictor of AF during follow-up (P < 0.001). P wave duration and dispersion measured before and during pacemaker implantation were not predictive of AF after pacemaker implantation in patients with isolated SSS.
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Kristensen et al. (2004) conducted a cohort in Isolated sick sinus syndrome (SSS) (n=109). Sinus and paced P wave duration and dispersion was evaluated on Atrial fibrillation during follow-up. Sinus and paced P wave duration and dispersion were not predictive of atrial fibrillation after pacemaker implantation, whereas bradycardia-tachycardia syndrome was a strong predictor (P<0.001).
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