P-wave duration and dispersion in patients with coronary slow flow and its relationship with thrombolysis in myocardial infarction frame count

2007 ◽  
Vol 40 (4) ◽  
pp. S23
Author(s):  
Sait Mesut Dogan ◽  
Nesligul Yildirim ◽  
Metin Gursurer ◽  
Mustafa Aydin ◽  
Ezgi Kalaycioglu Fatih Cam
Keyword(s):  
Myocardial Infarction ◽  
P Wave ◽  
Slow Flow ◽  
Wave Duration ◽  
P Wave Duration ◽  
Coronary Slow Flow

P-wave duration and dispersion in patients with coronary slow flow and its relationship with Thrombolysis in Myocardial Infarction frame count

2008 ◽  
Vol 41 (1) ◽  
pp. 55-59 ◽  
Author(s):  
Sait M. Dogan ◽  
Nesligul Yildirim ◽  
Metin Gursurer ◽  
Mustafa Aydin ◽  
Ezgi Kalaycioglu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
P Wave ◽  
Slow Flow ◽  
Wave Duration ◽  
P Wave Duration ◽  
Coronary Slow Flow

Abstract 2125: P Wave Morphology Is a Predictor of Poor Cardiac Outcome and Death in MADIT II Patients

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Fredrik Holmqvist ◽  
Pyotr G Platonov ◽  
Scott McNitt ◽  
Slava Polonsky ◽  
Jonas Carlson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Death ◽  
P Wave ◽  
Wave Duration ◽  
P Wave Duration ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Wave Morphology ◽  
Cardiac Outcome ◽  
Madit Ii

The objective of the present study was to non-invasively analyse atrial electrophysiology to identify markers associated with increased risk of mortality and deterioration of heart failure in a high-risk population with advanced CHF and a history of acute myocardial infarction. Patients included in MADIT II with sinus rhythm at baseline were studied (n=802). Unfiltered and bandpass filtered signal-averaged P waves were analyzed to determine orthogonal P wave morphology, P wave duration and RMS20. The association between P wave parameters and data on the clinical course and cardiac events during a mean follow-up of 20 months was analyzed. P wave duration was 139±23 ms and the RMS20 was 1.9±1.1 μV. None of these parameters were significantly associated with poor cardiac outcome. Differences in P wave morphology were independently predictive of non-sudden cardiac death (HR 2.66; 95% CI 1.41–5.04, P=0.0027). In addition, in univariate analyses differences in P wave morphology were found to be associated with an increased risk of all-cause mortality (HR 1.35; 95%CI 1.01–1.81, P=0.042) and cardiac death (HR 1.54; 95%CI 1.10 –2.16, P=0.011) (figure ) In the present study the value of analyzing the P wave morphology in patients with previous myocardial infarction and CHF is demonstrated. Changes in P wave morphology were shown to be independently predictive of increased risk of non-sudden cardiac death. Furthermore, statistically significant associations between P wave morphology changes and all-cause mortality, cardiac death and CHF hospitalization was demonstrated.

Prognostic of Interatrial Block after an Acute ST-Segment Elevation Myocardial Infarction

Cardiology ◽  
2019 ◽  
Vol 142 (2) ◽  
pp. 109-115 ◽  
Author(s):  
Vanesa Bruña ◽  
Jesús Velásquez-Rodríguez ◽  
María Jesús Valero-Masa ◽  
Beatriz Pérez-Guillem ◽  
Lourdes Vicent ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Sinus Rhythm ◽  
P Wave ◽  
St Segment Elevation ◽  
Acute Stemi ◽  
Wave Duration ◽  
Segment Elevation Myocardial Infarction ◽  
P Wave Duration ◽  
St Segment

Background: The influence of interatrial block (IAB) in the prognosis after an acute ST-segment elevation myocardial infarction (STEMI) is unknown. Objectives: To assess the prognostic impact of IAB after an acute STEMI regarding long-term mortality, development of atrial fibrillation, and stroke. Methods: Registry of 972 consecutive patients with STEMI and sinus rhythm at discharge, with a long-term follow-up (49.6 ± 24.9 months). P wave duration was analyzed using digital calipers, and patients were divided into three groups: normal P wave duration (<120 ms), partial IAB (pIAB) (P wave ≥120 ms and positive in inferior leads), and advanced IAB (aIAB) (P wave ≥120 ms plus biphasic [positive/negative] morphology in inferior leads). Results: Mean age was 62.6 ± 13.5 years. A total of 708 patients had normal P wave (72.8%), 207 pIAB (21.3%), and 57 aIAB (5.9%). Patients with aIAB were older (mean age 73 years) than the rest (62 years in the other two groups, p < 0.001). They also had a higher rate of hypertension (70 vs. 55% in pIAB and 49% in normal P wave, p = 0.006) and higher all-cause mortality (26.3 vs. 12.6% in pIAB and 10.3% in normal P wave, p = 0.001). However, multivariable analysis did not show an independent association between IAB and prognosis. Conclusion: About a quarter of patients discharged in sinus rhythm after an acute STEMI have IAB. Patients with aIAB have a poor prognosis, although this is explained mainly by the association of aIAB with age and other variables.

Advanced interatrial block precedes atrial fibrillation and stroke. The prospective interatrial Block And Yearly EventS (BAYES) registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Martinez-Selles ◽  
R Elosua ◽  
M Ibarrola ◽  
M De Andres ◽  
P Diez-Villanueva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Sinus Rhythm ◽  
Structural Heart Disease ◽  
P Wave ◽  
Wave Duration ◽  
P Wave Duration ◽  
Previous Diagnosis ◽  
Surface Ecg ◽  
Interatrial Block

Abstract Background Advanced interatrial block (IAB), prolonged and bimodal P waves in surface ECG inferior leads, is an unrecognized surrogate of atrial dysfunction and a trigger of atrial dysrhythmias, mainly atrial fibrillation (AF). Our aim was to prospectively assess whether advanced IAB in sinus rhythm precedes AF and stroke in elderly outpatients with structural heart disease, a group not previously studied. Methods Prospective observational registry that included outpatients aged ≥70 years with structural heart disease and no previous diagnosis of AF. Patients were divided into three groups according to P-wave characteristics. Results Among 556 individuals, 223 had normal P-wave (40.1%), 196 partial IAB (35.3%), and 137 advanced IAB (24.6%). After a median follow-up of 694 days; 93 patients (16.7%) developed AF, 30 stroke (5.4%), and 34 died (6.1%). Advanced IAB was independently associated with AF (hazard ratio [HR] 2.9, 95% confidence interval [CI] 1.7–5.1, p&lt;0.001), stroke (HR 3.8, 95% CI 1.4–10.7, p=0.010), and AF/stroke (HR 2.6, 95% CI 1.5–4.4, p=0.001). P-wave duration (ms) was independently associated with AF (HR 1.05, 95% CI 1.03–1.07, p&lt;0.001), AF/stroke (HR 1.04, 95% CI 1.02–1.06, p&lt;0.001), and mortality (HR 1.04, 95% CI 1.00–1.08, p=0.021). Conclusions The presence of advanced IAB in sinus rhythm is a risk factor for AF and stroke in an elderly population with structural heart disease and no previous diagnosis of AF. P-wave duration was also associated with all-cause mortality. Figure. Age- and sex-adjusted linear and non-linear association between P-wave duration (msec) and atrial fibrillation (A), stroke (B), and atrial fibrillation or stroke (C) risk. Results of a generalized additive model with spline smoothing functions and 4 degrees of freedom. Figure 1. Kaplan-Meyer curves of survival free of atrial fibrillation (A), stroke (B) and atrial fibrillation or stroke (C) in patients with normal P-wave, partial interatrial block (IAB) and advanced IAB. Funding Acknowledgement Type of funding source: None

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