Patients with hypertrophic cardiomyopathy exhibited a significantly longer P-wave duration compared to healthy controls (149 vs 130 ms, P<0.0001), suggesting a higher prevalence of interatrial conduction block.
Case-Control (n=130)
Single-blind (for ECG classification)
Yes
Does P-wave duration and morphology differ between patients with hypertrophic cardiomyopathy and healthy controls?
Patients with hypertrophic cardiomyopathy exhibit longer P-wave duration and altered P-wave morphology indicative of interatrial conduction block, which may explain their higher propensity for atrial fibrillation.
Absolute Event Rate: 149% vs 130%
p-value: p=<0.0001
BACKGROUND: Patients with hypertrophic cardiomyopathy (HCM) have a high incidence of atrial fibrillation. They also have a longer P-wave duration than healthy controls, indicating conduction alterations. Previous studies have demonstrated orthogonal P-wave morphology alterations in patients with paroxysmal atrial fibrillation. In the present study, the P-wave morphology of patients with HCM was compared with that of matched controls in order to explore the nature of the atrial conduction alterations. METHODS AND RESULTS: A total of 65 patients (45 men, mean age 49 +/- 15) with HCM were included. The control population (n = 65) was age and gender matched (45 men, mean age 49 +/- 15). Five minutes of 12-lead ECG was recorded. The data were subsequently transformed to orthogonal lead data, and unfiltered signal-averaged P-wave analysis was performed. The P-wave duration was longer in the HCM patients compared to the controls (149 +/- 22 vs 130 +/- 16 ms, P < 0.0001). Examination of the P-wave morphology demonstrated changes in conduction patterns compatible with interatrial conduction block of varying severity in both groups, but a higher degree of interatrial block seen in the HCM population. These changes were most prominent in the Leads Y and Z. CONCLUSION: The present study suggests that the longer P-wave duration observed in HCM patients may be explained by a higher prevalence of block in one or more of the interatrial conduction routes.
Holmqvist et al. (Sun,) conducted a case-control in Hypertrophic Cardiomyopathy (n=130). Hypertrophic cardiomyopathy (exposure) vs. Healthy age- and gender-matched controls was evaluated on P-wave duration (ms) (p=<0.0001). Patients with hypertrophic cardiomyopathy exhibited a significantly longer P-wave duration compared to healthy controls (149 vs 130 ms, P<0.0001), suggesting a higher prevalence of interatrial conduction block.