Abstract 14192: Stroke Recurrence and Atrial Fibrillation Occurrence in the Patients With Right Insular Stroke

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Hee-Kwon Park ◽  
Sang-Bae Ko ◽  
Joung-Ho Rha
Keyword(s):  
Recurrence Rate ◽  
Stroke Risk ◽  
Insular Cortex ◽  
Wave Dispersion ◽  
P Wave ◽  
Stroke Recurrence ◽  
Stroke Patients ◽  
P Wave Dispersion ◽  
Arrhythmogenic Potential ◽  
The Right

Introduction: The right insular cortical lesion is believed to have the arrhythmogenic potential such as secondary atrial fibrillation(AF). The P wave-triggered signal-averaged electrocardiogram(SA-ECG) can detect the P wave dispersion which is related to the risk of AF. The stroke risk of secondary AF after right insular stroke remained unclear. Hypothesis: We investigated the arrhythmogenic potential of right insular stroke, using SA-ECG and the stroke recurrence rate related to stroke location. Methods: We recruited acute stroke patients who admitted from February 2012 to October 2013 and took routine work-up, including SA-ECG. Patients who had the previous history of AF before admission, were excluded. We checked the stroke recurrence and AF occurrence over two years after index stroke. We analyzed the difference of SA-ECG, AF occurrence and stroke recurrence rate between the right insular cortex lesion and other stroke. Results: A total of 252 subjects were enrolled and 49 among them had right insular involvement. The patients with right insular lesion had longer P wave duration than the other stroke patients (154.0+29.6 vs. 133.5+26.5 ms, p<0.001). During observation period, stroke recurred in 28 patients and AF occurred in 50 persons. The patients with right insular lesion suffered from the AF occurrence and the stroke recurrence more frequently than those with other stroke lesions(AF occurrence, 33% vs 17%, P=0.01; Stroke Recurrence 25% vs 6%, P<0.01). Among the patients with AF occurrence, the patients with right insular lesion had the tendency of the higher stroke recurrence rate than those with the other stroke lesion(43.8% vs 20.6%, P=0.089). Conclusions: Our result suggests that the right insular lesion is related to increased P wave dispersion and this might explain the development of secondary AF after right insular cortex stroke. Secondary AF after right insular lesion might have the higher stroke risk than that after other stroke lesion.

Abstract 207: Signal Averaged Electrocardiogram can Indicate the Arrhythmogenic Potential of Right Insular Stroke

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Hee-Kwon Park ◽  
Cindy W Yoon ◽  
Ji-Won Kwon ◽  
Soo-Jeong Kim ◽  
Eung-Seok Lee ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Insular Cortex ◽  
Wave Dispersion ◽  
P Wave ◽  
Stroke Patients ◽  
P Wave Dispersion ◽  
Wave Duration ◽  
P Wave Duration ◽  
The Right

Backgrounds: The right insular cortical stroke is believed to have arrhythmogenic potential such as secondary atrial fibrillation (AF). The P wave-triggered signal-averaged electrocardiogram (SA-ECG) can reveal the P wave dispersion which is associated with the risk of AF in the future. However, there has been no relevant clinical study and we investigated the P wave dispersion after stroke involving right insula. Methods: We recruited acute stroke patients consecutively, who admitted from February 2012 to October 2013 and took routine work-up with SA-ECG. Patients who had AF on admission were excluded. SA-ECG was followed up two years after stroke onset. Significant P-wave dispersion was defined as ‘P-wave duration (PWD) >125ms for the predictor of future AF risk. We analyzed the difference of SA-ECG between the right insular cortex lesion and other stroke. Results: A total of 252 subjects were enrolled and 49 among them had right insular involvement. Follow up SA-ECG were available in 69 patients. In acute stroke period, the patients with right insular lesion had longer P wave duration than the other stroke patients (154.0+29.6 vs. 133.5+26.5 ms, p<0.001). In the patients with right insular involvement, prolonged P wave duration in acute period was shortened in follow up SA-ECG after two years (n=17, 164.5+35.2 vs. 131.7+22.3 ms, p=0.003). However, patients with other stroke lesion did not show such interval change. During observation period, AF occurred more frequently in the subjects with right insular lesion than other stroke patients (33% vs 17%, p=0.01). Conclusion: Our data suggest that the right insular lesion is associated with increased P wave dispersion transiently in acute stroke period and this might explain the development of secondary AF shortly after right insular cortex stroke.

scholarly journals The Relationships between the Repolarisation and Depolarisation Markers of Sudden Cardiac Death in Smokers

2020 ◽  
Vol 9 (1) ◽  
pp. 5-5
Author(s):  
Ayhan Cosgun ◽  
Mustafa Hamidullah Türkkanı
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Simple Random Sampling ◽  
Wave Dispersion ◽  
P Wave ◽  
Control Group ◽  
Study Group ◽  
P Wave Dispersion ◽  
Significant Difference ◽  
The Right

Backgroung: The risk of sudden cardiac death (SCD) and atrial fibrillation (AF) increase in smokers. This study aimed to determine the relationships between the repolarization and depolarization predictors of SCD in routine electrocardiography (ECG) in smokers. Methods: Between January and August-2019, ninety-eight healthy patients smoking for more than five years were included in the study group by simple random sampling. The control group consisted of one hundred twenty-two non-smokers. In the study and control group, following a routine physical examination and blood tests, P wave dispersion in the right precordial leads (PWdR) and the left precordial leads (PWdL), T peak-end interval in the right precordial leads (Tp-eR) and the left precordial leads (Tp-eL), QRS dispersion in the right precordial leads (dQRSR) and the left precordial leads (dQRSL), and QRS duration values in the right precordial leads (QRSR) and the left precordial leads (QRSL) were calculated in routine 12-lead ECG + right precordial leads. Results: There was a statistically significant moderate positive correlation between dQRSRxTp-eR/QRSR-value and smoking time in the study group. Also, there was a statistically significant weak negative correlation between dQRSLxTp-eL/QRSL-value and smoking time in the study group (Respectively, R=0.52, and P<0.01, R=0.41 and P<0.01). There was a significant difference between correlation ratio of dQRSRxTp-eR/QRS-value and smoking time and dQRSLxTp-eL/QRSL-value and smoking time in the study group (Z=5.73, p<0.01). Conclusions: In the current smokers, dQRSRxTp-eR/QRSR and dQRSLxTp-eL/QRSL values significantly higher than in the control group.

TO STUDY THE EFFECT OF BMV ON P WAVE DISPERSION AND SHORT TERM PROGNOSTIC IMPACT OF P WAVE DISPERSION IN PREDICTION OF CLINICAL OUTCOME AFTER PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY IN PATIENTS WITH MITRAL STENOSIS AND SINUS RHYTHM

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Ashish Kumar Agarwal ◽  
Daulat Singh Meena ◽  
Vijay Pathak ◽  
Anoop Jain ◽  
Rakesh Kumar Ola
Keyword(s):  
Clinical Outcome ◽  
Right Ventricular ◽  
Wave Dispersion ◽  
Tissue Doppler ◽  
P Wave ◽  
Short Term ◽  
P Wave Dispersion ◽  
Mitral Valvuloplasty ◽  
Percutaneous Balloon ◽  
Before And After

Background: The aim of the present study was to study the effect of percutaneous balloon mitral  valvuloplasty (PBMV) on P wave dispersion and to test the correlation between P-maximum and  P-dispersion to right ventricular function and pulmonary artery pressure before and after PMBV. Also to study the impact of P-maximum and P-wave dispersion on the short term clinical outcome after successful PBMV in patients with mitral stenosis (MS) and sinus rhythm. Methods: 75 patients undergoing PMBV were enrolled in this study. We evaluated P-maximum, P-minimum and P-wave dispersion before and one month and one year after PBMV . We studied the changes in pulmonary arterial pressure (PAP), left atrial (LA) dimension, mitral diastolic gradient, and mitral valve area, in addition to the changes in right ventricular function utilizing tissue Doppler assessment both before and after PMBV, in addition the role of the P-wave dispersion in prediction of late cardiac events. Results: There were significant decrease in mean diastolic gradient, PAP, and LA size and significant improvement in right ventricular tissue Doppler indices after PMBV. Accompany these hemodynamic changes after PMBV. P-maximum and P-wave dispersion were found to be decreased (P < 0.001). Conclusion: Successful PBMV was associated with a decrease in Pmax and PWD. These simple electrocardiographic indices may predict the success of the procedure immediately after PBMV.  The P-maximum and P-wave dispersion changes were correlated with significant impairment of right dysfunction and the degree of pulmonary artery pressure. Keywords: PBMV.PAP,LA

scholarly journals Evaluation of left atrial mechanics and p-wave dispersion as markers of left atrial cardiopathy in patients of embolic stroke of undetermined source (ESUS)

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Masood ◽  
M.M Azharuddin ◽  
S.M.K Ashraf ◽  
S Wahab
Keyword(s):  
Left Atrial ◽  
Wave Dispersion ◽  
Embolic Stroke ◽  
P Wave ◽  
Electromechanical Delay ◽  
P Wave Dispersion ◽  
Atrial Electromechanical Delay ◽  
Wave Duration ◽  
P Wave Duration ◽  
Increased Risk

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&lt;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

P Wave Dispersion in Hypertensive Patients with Paroxysmal Atrial Fibrillation

2000 ◽  
Vol 23 (11P2) ◽  
pp. 1859-1862 ◽  
Author(s):  
NECLA ÖZER ◽  
KUDRET AYTEMIR ◽  
ENVER ATALAR ◽  
ELIF SADE ◽  
SERDAR AKSÖYEK ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Wave Dispersion ◽  
P Wave ◽  
P Wave Dispersion ◽  
Hypertensive Patients

Vectorial theory surpasses the local theory in explaining the origin of P-wave dispersion

2021 ◽  
Author(s):  
Raimundo Carmona Puerta ◽  
Elizabeth Lorenzo Martínez ◽  
Magda Alina Rabassa López-Calleja ◽  
Gustavo Padrón Peña ◽  
Juan Miguel Cruz Elizundia ◽  
...  
Keyword(s):  
Wave Dispersion ◽  
P Wave ◽  
Local Theory ◽  
P Wave Dispersion

scholarly journals Impaired atrial electromechanical coupling in lichen planus patients

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
I Jafaripour ◽  
Z Aryanian ◽  
S Hosseinzadeh ◽  
R Pourkia ◽  
MM Ansari Ramandi ◽  
...  
Keyword(s):  
Lichen Planus ◽  
Electromechanical Coupling ◽  
Wave Dispersion ◽  
Tissue Doppler ◽  
P Wave ◽  
Control Group ◽  
P Value ◽  
P Wave Dispersion ◽  
Increased Risk ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Lichen planus (LP) which is a chronic inflammatory disease can cause impaired atrial electromechanical coupling, leading to increased risk of atrial fibrillation. Purpose The present study aimed to evaluate atrial electromechanical coupling in LP patients by using electrocardiography (ECG) and echocardiography. Methods Forty-six LP patients were investigated in this cross-sectional case-control study. The control group comprised healthy individuals selected in age and gender-matched manner. Echocardiography and ECG were done for all patients to show inter and intra-atrial electromechanical delays and P wave dispersion respectively. The electromechanical delays were calculated by using the difference between the delays from the onset of the P wave on ECG to the onset of A wave on tissue Doppler recordings of the different areas. Results The baseline characteristics of the case and control group were similar and did not differ significantly. The P wave dispersion was 45.63 ± 3.48 milliseconds in the LP group in comparison to 36.56 ± 2.87 milliseconds in the control group (p &lt; 0.001). As shown in the table, the intra and inter-atrial electromechanical delays were also significantly prolonged in LP patients when compared to the control group (p &lt; 0.001). There was no significant difference between the left and right ventricular systolic function and diastolic function of the two groups. Conclusion The results of the study indicate the presence of significant impaired atrial electromechanical coupling in patients with LP confirmed by both electrocardiographic and echocardiographic tools. Electromechanical delays Case N = 46 (mean ± SD) Control N = 46 (mean ± SD) P value Septal - PA (msec) 59.71 ± 13.24 44.39 ± 11.07 0.002 Lateral - PA (msec) 55.71 ± 13.26 48.89 ± 11.21 0.009 Tricuspid - PA (msec) 52.37 ± 13.12 43.28 ± 10.58 0.002 Inter-atrial delay (msec) (lateral PA−RV PA) 8.47 ± 1.62 6.37 ± 1.36 &lt;0.001 Intra-atrial delay (msec) (LA) [lateral PA−septal PA] 4.80 ± 1.48 3.83 ± 0.82 &lt;0.001 Intra-atrial delay (msec) (RA) [septal PA−RV PA] 3.91 ± 0.96 2.02 ± 0.71 &lt;0.001 PA Delay from the onset of the P wave on ECG to the onset of A wave on tissue Doppler, N: number, SD: Standard Deviation, LA: Left Atrium, RA: Right Atrium, RV: Right Ventricle

Sign in / Sign up

Export Citation Format

Share Document