P2110 Evaluation of sinus and paced P-wave duration and P-wave dispersion as predictors for developing atrial fibrillation during pacemaker treatment in patients with sick sinus syndrome

Abstract Introduction Around 25% of all ischaemic strokes have no known cause despite standard investigations. Most of these cases are suspected to have an embolic source for ischaemia, leading to the moniker of Embolic Stroke of Undetermined Source (ESUS). Recent studies suggest that abnormalities of the left atrium, in the form of atrial cardiopathy, can lead to increased risk of stroke even in the absence of atrial fibrillation (AF), which may be either as precursors to AF or as independent risk factors for the development of left atrial thrombus and subsequent stroke. Purpose The aim of this study was to measure LA electromechanical dissociation, LA volumes and P-wave dispersion as markers of atrial cardiopathy in patients with ESUS to determine whether atrial cardiopathy may be in the causal pathway of ESUS. Methods 28 patients presenting with ischaemic stroke and fulfilling the criteria for ESUS were enrolled into this cross-sectional, observational study. All patients had 24-hour Holter monitoring done to rule out the presence of AF. The control group consisted of 28 age- and gender-matched apparently healthy individuals. On ECG, P-wave Dispersion (PWD) was calculated by subtracting minimum P-wave duration from maximum P-wave duration. On echocardiography, time intervals from the beginning of P-wave to beginning of A' wave from the lateral mitral annulus in tissue doppler imaging was measured as the atrial electromechanical delay. LA volumes were recorded using the Modified Biplane Simpson's method. Statistical analysis was performed using student's t-test, chi-square test, and Pearson's test. Results Baseline demographic and laboratory characteristics were similar between the two groups. Increased PWD (34.14±9.89 ms vs. 27.32±8.95 ms; p=0.01), atrial electromechanical delay (73.32±16.31 ms vs. 63.63±13.59 ms; p=0.02) and LA volumes were observed in patients with ESUS as compared to controls. A significant correlation was also found between these parameters (p<0.01). Discussion According to the results of our study, PWD, atrial electromechanical delay and LA volumes may be novel predictors for ESUS. Atrial cardiopathy is a unique mechanism of thrombo-embolism in ESUS patients and our data establishes its association with ESUS. Further studies will be needed to shed more light on its role in the causality of stroke in the ESUS population. Measurement of electromechanical delay Funding Acknowledgement Type of funding source: None

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Maximum P Wave Duration and P Wave Dispersion in Adult Patients with Secundum Atrial Septal Defect: The Impact of Surgical Repair

Annals of Noninvasive Electrocardiology ◽

10.1111/j.1542-474x.2004.92532.x ◽

2004 ◽

Vol 9 (2) ◽

pp. 136-141 ◽

Cited By ~ 25

Author(s):

Umit Guray ◽

Yesim Guray ◽

Burcu Mecit ◽

M. Birhan Yilmaz ◽

Hatice Sasmaz ◽

...

Keyword(s):

Atrial Septal Defect ◽

Septal Defect ◽

Surgical Repair ◽

Wave Dispersion ◽

P Wave ◽

Secundum Atrial Septal Defect ◽

P Wave Dispersion ◽

Wave Duration ◽

P Wave Duration ◽

The Impact

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A40-5 Increased P wave duration and P wave dispersion in patients with scleroderma

EP Europace ◽

10.1016/s1099-5129(03)91739-9 ◽

2003 ◽

Vol 4 ◽

pp. B62-B63

Author(s):

I CAN

Keyword(s):

Wave Dispersion ◽

P Wave ◽

P Wave Dispersion ◽

Wave Duration ◽

P Wave Duration

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P-Wave Duration and Dispersion in Patients with Mitral Stenosis

10.21203/rs.3.rs-200176/v1 ◽

2021 ◽

Author(s):

Wenxia Fu ◽

Jiawei Le ◽

Xijin Wei ◽

lixiu chen ◽

Wenzhao Li ◽

...

Keyword(s):

Mitral Stenosis ◽

Test Group ◽

Wave Dispersion ◽

Left Ventricular ◽

P Wave ◽

Control Group ◽

P Wave Dispersion ◽

Wave Duration ◽

P Wave Duration ◽

Increased Risk

Abstract Background: Mitral stenosis (MS) is related to prolonged inter- and intra-atrial electromechanical delays and increased P-wave dispersion. The objective of the current study was to investigate the correlation between the P-wave duration, P-wave dispersion (PWD), mitral stenosis (MS) and to explore the cut-off values for predicting the MS in the patients.Methods: We enrolled 62 patients with MS and sinus rhythm as test group, and 62 healthy subjects matched in age- and sex- were selected as control group. We conducted the 12-lead electrocardiogram and echocardiography for all the subjects. The maximum and the minimum P-wave duration and PWD were calculated. Univariate and multivariate logistic regression analyses were performed to demonstrate the correlation between P-wave duration and PWD and MS. The receiver operating characteristic (ROC) curve was drawn to detect the threshold of P-wave duration and PWD for predicting the MS.Results: There were significant differences in the left atrial diameter (45.00±5.78 vs. 32.31±4.24 cm2), pulmonary artery pressure (46.68±17.29 vs. 32.64±2.86 mm Hg), left ventricular end-diastolic diameter (47.57±4.80 vs. 45.58±5.04 cm), ejection fraction (63.10±3.05 vs. 65.13±2.56%), aortic root inside diameter (29.60±3.50 vs. 31.58±3.58) and pulmonary trunk (24.17±2.78 vs. 22.23±1.77) values between the test group and the control group. Besides, the test subjects had significantly longer maximum P-wave duration (123.42±12.33 vs. 108.18±9.07) and larger P-wave dispersion (47.24±13.61 vs. 28.94±9.19). In the multivariate analysis, maximum P-wave duration (OR:1.221, 95% CI:1.126-1.324) and P-wave dispersion (OR:1.164, 95% CI:1.094-1.238) were correlated with the occurrence of MS. The optimal threshold for the maximum P-wave duration and PWD were 119.50ms, and 42.50ms, respectively, and the areas under the curve were 0.859 and 0.865, respectively. Conclusions: A longer P-wave duration and a higher PWD are correlated with the increased risk of MS progression.

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