P-wave peak time prolongation is associated with cardiogenic cerebral infarction in patients with paroxysmal atrial fibrillation

OBJECTIVE This research investigates whether P-wave peak time (PWPT), a new electrocardiographic index, is associated with cardiogenic cerebral infarction (CCI) in individuals with paroxysmal atrial fibrillation (PAF). METHODS Seventy patients with PAF complicated by CCI were enrolled in the PAF-CCI group, and another 70 patients with PAF without cerebral infarction (CI) were matched as the PAF-non-CI group. Comprehensive demographic, electrocardiogram data, and laboratory were collected and measured from two groups of subjects and compared between the groups. RESULTS PWPT in lead V1 and D2 (PWPT-V1 and PWPT-D2), P-wave dispersion (PWd), P-wave duration (PWdur), Maximum PWdur (Pmax), Minimum PWdur (Pmin), QT interval (QT), and PR interval (PR) in the PAF-CCI group were notably longer, while heart rate (HR) was notably slower than those in the PAF-non-CI group. In multivariate analysis, PWPT-D2 remained an independent risk factor for PAF-CCI, along with age, PWd, PWPT-V1 and QT. PWPT-D2 exhibited the highest discriminatory power among these variables (AUC = 0.910). When the optimal cutoff was set at >58.25 ms, the sensitivity was 95.7% and the specificity was 90.0%. CONCLUSION PWPT-D2 is independently associated with CCI in PAF patients and holds predictive value for CCI development in PAF patients.