Atrial conduction explains the occurrence of the P‐wave dispersion phenomenon, but weakly

Figures

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  FIGURE 1. Example of measurement methods in a 68‐year‐old male patient diagnosed with atrioventricular nodal reentrant tachycardia and previous history of systemic hypertension. (A) Method used for the measurement of P‐wave dispersion using a 12‐lead simultaneous recording and hand‐held caliper. Pmax and Pmin were measured in the same beat to avoid the phenomenon of P‐wave lability over time. (B) Method used for the measurement of atrial conduction times (P‐A intervals). DCS, distal coronary sinus; HIS, atrial electrogram in the His bundle recording; HRA, high right atrium; P, earliest onset of the P wave; PCS, proximal coronary sinus; Pmax, maximum P‐wave duration; Pmin, minimum P‐wave duration; PWD, P‐wave dispersion

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  FIGURE 2. Results of the correlation of all the electrophysiological parameters studied with the P‐wave dispersion. HRAm, HISm, PCSm, DCSm/HRAdur, HISdur, PCSdur, DCSdur: morphology of atrial electrograms/duration of each local electrogram in high right atrium, histogram area, proximal coronary sinus and distal coronary sinus, respectively; P‐HRA, P‐HIS, P‐PCS, P‐DCS (interatrial conduction time): P‐A intervals; ΔHIS‐HRA, ΔPCS‐HRA, ΔPCS‐HIS, ΔDCS‐PCS (intraleft atrial conduction time): activation difference between two regions

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  FIGURE 3. ROC (receiver operating characteristic) curves showing the relationship between sensitivity and specificity through all the possible P‐wave dispersion values that define patients with ΔDCS‐PCS (blue curves) and P‐DCS (mauve curves) ≥75 percentile. A and B: in all patients; C and D: in patients with AVNRT; F and G: in patients with accessory pathways. AVNRT, atrioventricular nodal reentrant tachycardia; ΔDCS‐PCS, intraleft atrial conduction time; P‐DCS, interatrial conduction time