P-wave duration is a predictor for long-term mortality in post-CABG patients

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.

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A comparison of P-wave duration and dispersion in patients with short-term and long-term atrial fibrillation

Journal of Electrocardiology ◽

10.1016/s0022-0736(03)00049-9 ◽

2003 ◽

Vol 36 (3) ◽

pp. 251-255 ◽

Cited By ~ 20

Author(s):

Abdullah Dogan ◽

Gurkan Acar ◽

Omer Gedikli ◽

Mehmet Ozaydin ◽

Cem Nazli ◽

...

Keyword(s):

Atrial Fibrillation ◽

P Wave ◽

Short Term ◽

Wave Duration ◽

P Wave Duration

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Effects of long-term beta-blocker therapy on P-wave duration and dispersion in patients with rheumatic mitral stenosis

International Journal of Cardiology ◽

10.1016/j.ijcard.2004.03.079 ◽

2005 ◽

Vol 102 (1) ◽

pp. 33-37 ◽

Cited By ~ 20

Author(s):

Ali Riza Erbay ◽

Hasan Turhan ◽

Ayse Saatci Yasar ◽

Asuman Bicer ◽

Kubilay Senen ◽

...

Keyword(s):

Beta Blocker ◽

Mitral Stenosis ◽

P Wave ◽

Blocker Therapy ◽

Beta Blocker Therapy ◽

Wave Duration ◽

Rheumatic Mitral Stenosis ◽

P Wave Duration

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Prolonged Signal -Averaged P-Wave Duration and the Long-Term Risk of Permanent Atrial Fibrillation

EP Europace ◽

10.1016/j.eupc.2005.08.070 ◽

2005 ◽

Vol 7 ◽

pp. S27-S27

Author(s):

U DIXEN ◽

L RAVN ◽

M LARSEN ◽

J PARNER ◽

G JENSEN

Keyword(s):

Atrial Fibrillation ◽

P Wave ◽

Wave Duration ◽

P Wave Duration ◽

Permanent Atrial Fibrillation

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Long-term effects of beta blocker therapy on P-wave duration and dispersion in congestive heart failure patients: A new effect?

Journal of Electrocardiology ◽

10.1054/jelc.2003.50020 ◽

2003 ◽

Vol 36 (2) ◽

pp. 111-116 ◽

Cited By ~ 17

Author(s):

Ahmet Çamsari ◽

Hasan Pekdemir ◽

M.Necdet Akkus ◽

Senay Yenihan ◽

Oben Döven ◽

...

Keyword(s):

Heart Failure ◽

Congestive Heart Failure ◽

Beta Blocker ◽

P Wave ◽

Long Term Effects ◽

Blocker Therapy ◽

Heart Failure Patients ◽

Wave Duration ◽

P Wave Duration

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Characterization of superresponders to cryoballoon ablation

European Heart Journal ◽

10.1093/eurheartj/ehab724.0348 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

J Marti Almor ◽

B Casteigt ◽

J Jimenez-Lopez ◽

J Conejos ◽

E Valles ◽

...

Keyword(s):

Pulmonary Veins ◽

Left Ventricular ◽

P Wave ◽

Left Ventricular Ejection ◽

Cryoballoon Ablation ◽

Ventricular Ejection Fraction ◽

Wave Duration ◽

P Wave Duration ◽

Ablation Index

Abstract Background Isolation of pulmonary veins is the cornerstone in the treatment of symptomatic atrial fibrillation rather with radiofrequency or cryo balloon. Recurrence rate is quite common in the long term follow up, clearly related to previosly described factors. Nevertheless some patients maintain sinus rhythm forever after the index ablation. The aim of this study is characterize this kind of patients (so called superresponders). Methods This is a Unicentric, retrospective, consecutive study including all patients summited for cryoablation in our hospital from January 2011 to September 2020. We looked for clinical, electrical, echocardiographic variables and those linked to the ablation procedure. A transversal FU to discard recurrences was done. A univariate and multivariate logistic regression was performed. Results We included 422 patients, 193 of them were finally excluded: 21 lost in the FU, 30 got radiofrequency ablation and 142 did not reach a minimum 5 years FU. About the 229 finally included, 85 (group 1) didn't have any recurrence during the FU, in front of 144 (group2) with recurrences. The univariate analysis showed that grup 1 patients were younger, the rate of hypertension, CHA2DS2VASc score, moderate sleep apnea, body mass index (BMI), p wave duration, and the size of left atrial was lower in grup 1 in front of patients of grup 2. Left ventricular ejection fraction was higher and the number of pulmonary veins in whom the temperature was lower than −40°C in grup 1 in front to grup 2. In the multivariate analysis the p wave duration: OR 0.92; 95% CI [0.89–0.94]; p<0.001, BMI kg/m2: OR 0.74; 95% CI [0.65–0.85]; p<0.001, a temperature <−40°C in all the targeted veins: OR 3.52 95% CI [1.45–8.54]; p=0.005 and SR on the ablation index day OR: 7.29; 95% CI [1.53–34.71]; p=0.012, maintained statistical significance. Conclusions In our series patients with a p wave duration, BMI, SR the ablation index day and achieving a temperature <−40°C in all the targeted veins, resulted as protective factors to maintain SR in the long term FU. An adequate selection of patients can improve results and optimize resources. FUNDunding Acknowledgement Type of funding sources: None.

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Characterization of “Super-Responders” to Cryoballoon Ablation

Austin Journal of Clinical Cardiology ◽

10.26420/austinjclincardiolog.2021.1082 ◽

2021 ◽

Vol 7 (3) ◽

Author(s):

Martí-Almor J ◽

◽

Casteigt B ◽

Jiménez-López J ◽

Conejos J ◽

...

Keyword(s):

Statistical Significance ◽

Pulmonary Veins ◽

P Wave ◽

Cryoballoon Ablation ◽

Wave Duration ◽

P Wave Duration ◽

Ablation Index ◽

Group 2

Background: Pulmonary Veins Isolation (PVI) is the cornerstone in the treatment of atrial fibrillation. Recurrence rate is common in the long-term followup (FU); nevertheless, some patients maintain Sinus Rhythm (SR) for more than 5 years after the index ablation. The aim of this study is characterize this kind of patients so called “super-responders”. Methods: This is a retrospective single-center study including all patients summited for cryo-balloon ablation in our hospital from January 2011 to September 2020. We investigated clinical, electrocardiographic, echocardiographic variables and those linked to the ablation procedure. A univariate and multivariate logistic regression was performed. Results: During this period, 422 patients underwent PVI; however, 193 were excluded: 21 lost in the FU, 30 got radiofrequency ablation and 142 did not reach a minimum 5 years FU. Of the 229 finally included, 85 (group 1) did not have any recurrence during the follow-up, in front of 144 (group 2) with AF recurrences. In the multivariate analysis the p wave duration: OR: 0.92; 95% CI (0.89-0.94); p <0.001, BMI kg/m²: OR: 0.74; 95% CI (0.65-0.85); p <0.001, a temperature <-40°C in all the targeted veins: OR: 3.52; 95% CI (1.45-8.54); p=0.005 and SR on the ablation index day OR: 7.29; 95% CI (1.53-34.71); p=0.012, maintained statistical significance. Conclusions: In our series the p wave duration, BMI, the presence of SR the ablation index day and achieving a temperature <-40°C in all the targeted veins, resulted as protective factors to maintain SR in the long term follow-up. An adequate selection of patients probably could improve results and optimize resources.

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