scholarly journals The effect of recanalization of a chronic total coronary occlusion on P-wave dispersion

2021 ◽  
Vol 13 (3) ◽  
pp. 222-227
Author(s):  
Aydın Rodi Tosu ◽  
Muhsin Kalyoncuoğlu ◽  
Halil İbrahim Biter ◽  
Sinem Çakal ◽  
Beytullah Çakal ◽  
...  
Keyword(s):  
Wave Dispersion ◽  
Coronary Intervention ◽  
P Wave ◽  
Clinical Aspects ◽  
Target Vessel ◽  
Total Occlusion ◽  
P Wave Dispersion ◽  
Target Vessel Revascularization ◽  
Significant Difference

Introduction: P-wave dispersion (PWD) obtained from the standard 12-lead electrocardiography (ECG) is considered to reflect the homogeneity of the atrial electrical activity. The aim of this investigation was to evaluate the effect of percutaneous chronic total occlusion (CTO) revascularization on the parameters of P wave duration and PWD on ECG in cases before and after procedure at 12th months. Methods: We analyzed 90 consecutive CTO cases who were on sinus rhythm and underwent percutaneous coronary intervention (PCI). P-wave maximum (P-max) and P-wave minimum (P-min), P-wave time, and PWD were determined before and twelve months after the CTO intervention. The study population was categorized into two groups as successful and unsuccessful CTO PCI groups. Results: The CTO PCI was successful in 71% of cases (n=64) and it was unsuccessful in 29% of cases (n=26). Both groups, except for age and hypertension, were similar in terms of demographic and clinical aspects. CRP levels were significantly elevated in the unsuccessful CTO PCI group. Pre-PCI ECG parameters showed no significant difference. Irrespective of the target vessel revascularization, we observed that PWD and P-max values were significantly lower in the 12th months follow-up. In all Rentrop classes, PWD values were significantly decreased at 12th months follow-up in comparison to the pre-CTO PCI values. Conclusion: This study has determined that PWD and P-max, which are both risk factors for atrial arrhythmias, are significantly reduced within 12th months after successful CTO PCI regardless of the target vessel.

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 < 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 < 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 <0.001 Intra-atrial delay (msec) (LA) [lateral PA−septal PA] 4.80 ± 1.48 3.83 ± 0.82 <0.001 Intra-atrial delay (msec) (RA) [septal PA−RV PA] 3.91 ± 0.96 2.02 ± 0.71 <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

Atrial Fibrillation after Percutaneous Coronary Intervention: Predictive Importance of Clinical, Angiographic Features and P-Wave Dispersion

Cardiology ◽  
2007 ◽  
Vol 107 (3) ◽  
pp. 203-208 ◽  
Author(s):  
Bulent Gorenek ◽  
Afsin Parspur ◽  
Bilgin Timuralp ◽  
Alparslan Birdane ◽  
Necmi Ata ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Percutaneous Coronary Intervention ◽  
Wave Dispersion ◽  
Coronary Intervention ◽  
P Wave ◽  
P Wave Dispersion ◽  
Percutaneous Coronary

scholarly journals Transcatheter closure of atrial septal communication: impact on P-wave dispersion, duration, and arrhythmia in mid-term follow-up

2018 ◽  
pp. 1465-1473 ◽  
Author(s):  
Maria Lelakowska ◽  
Monika Komar ◽  
Paweł T. Matusik ◽  
Jadwiga Nessler ◽  
Piotr Podolec ◽  
...  
Keyword(s):  
Transcatheter Closure ◽  
Wave Dispersion ◽  
P Wave ◽  
P Wave Dispersion

–455 G/A polymorphism and preprocedural plasma levels of fibrinogen show no association with the risk of clinical restenosis in patients with coronary stent placement

2005 ◽  
Vol 93 (03) ◽  
pp. 564-569 ◽  
Author(s):  
Pascalle Monraats ◽  
Jamal Rana ◽  
Aeilko Zwinderman ◽  
Moniek de Maat ◽  
John Kastelein ◽  
...  
Keyword(s):  
Stent Placement ◽  
Fibrinogen Level ◽  
Coronary Intervention ◽  
Multivariate Regression Analysis ◽  
Coronary Stent ◽  
Target Vessel ◽  
Target Vessel Revascularization ◽  
Stent Restenosis ◽  
Increased Risk

SummaryThe effect of preprocedural fibrinogen levels on in-stent restenosis is largely unknown. The –455 G/A polymorphism of the fibrinogen β-gene is associated with baseline plasma level or acute phase increase of fibrinogen. Therefore, we hypothesized that there is a relationship between this polymorphism and pre-procedural fibrinogen level and clinical restenosis at follow-up among patients with coronary stent placement. The GENetic DEterminants of Restenosis (GENDER) project is a multicenter follow-up study that enrolled 3,146 consecutive patients after successful percutaneous coronary intervention. A coronary stent was placed in 2,309 patients. Of these, 2,257 (97.7%) patients were successfully genotyped for the –455G/A polymorphism. Plasma fibrinogen levels were measured at baseline in a subpopulation of 623 stented patients with the von Clauss method and patients were grouped into tertiles according to fibrinogen levels. Primary endpoint was target vessel revascularization (TVR); secondary combined endpoint was defined as death presumably from cardiac causes, MI not attributable to another coronary artery than the target vessel, and TVR. No association was observed between the –455G/A polymorphism and TVR or combined endpoint (p=0.99, p=0.97, respectively). Multivariate regression analysis revealed that the risk of TVR and combined endpoint was not higher for patients in the highest tertile for fibrinogen versus the lowest tertile (RR=0.60, 95% CI: 0.26–1.37 for TVR, RR=0.64, 95% CI: 0.29–1.44 for combined endpoint). In conclusion, the presence of –455G/A polymorphism in the fibrinogen β-gene and preprocedural fibrinogen level is not associated with an increased risk of TVR or combined endpoint in a patient population with coronary stent placement. Therefore, these parameters are not worthwhile for stratifying patients at risk for restenosis prestenting.

scholarly journals Prediction of Reperfusion and Infarct-Related Artery Patency after Thrombolysis in Acute Anterior Myocardial Infarction by Degree of P Wave Dispersion on ECG

2018 ◽  
Vol 32 (2) ◽  
pp. 100-105
Author(s):  
Md Monir Hossain Khan ◽  
Md Afzalur Rahman ◽  
Abdullah Al Shafi Majumder ◽  
Md Toufiqur Rahman ◽  
Md Monsurul Haque ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Wave Dispersion ◽  
P Wave ◽  
P Wave Dispersion ◽  
Timi Flow Grade ◽  
Group I ◽  
St Segment ◽  
Significant Difference ◽  
Infarct Related Artery ◽  
Group Ii

Background: The prognosis of patients with persistent occlusion of the infarct related artery (IRA), despite lytic therapy is poor. Early detection of successful reperfusion and IRA patency is of great importance in terms of prognosis and identification of candidates for rescue percutaneous coronary intervention (PCI). P wave dispersion (PWD), a new parameter measured before and after fibrinolytic therapy (FT) is supposed to predict successful reperfusion in patients with anterior acute myocardial infarction (AMI).Objectives:To examine the prediction of successful reperfusion and infarct related artery (IRA) patency by measuring P wave dispersion in 12-lead surface ECG.Method:132 patients were selected and divided into two groups on the basis of ST segment resolution (STR) after 120 minutes of thrombolysis. Group I: patients with STR >70%; Group II: patients with STR < 70%. All patients underwent coronary angiography (CAG). IRA patency was considered if TIMI flow grade was >2.Results: Mean age of the successfully thrombolysed group was 49.12±9.54 and mean age of failedthrombolysis group was 52.08±8.23 years. Though higher age was associated with failed thrombolysis and it was statistically insignificant (p=0.06). Patients with higher BMI showed no significant difference in thrombolysis. It was observed that diabetes mellitus and dyslipidemia were significantly higher in group II patients (p=0.04 and p=0.03, respectively). The mean level of PWD after 120 minutes of thrombolysis (PWD120) was statistically significant (p=0.001) between two groups. After multivariate regression analysis PWD120 was found to be the significant predictor of ST segment resolution as well as IRA patency (OR = 1.101; 95% CI = 1.012 – 1.240; p = 0.01).Conclusion: P wave dispersion (PWD) in patients receiving thrombolytic therapy can be a predictor of successful reperfusion and patent infarct related artery (IRA). PWD values, in combination with other reperfusion parameters, can contribute to the identification of rescue PCI candidates.Bangladesh Heart Journal 2017; 32(2) : 100-105

scholarly journals Safety of 3‐Month Dual Antiplatelet Therapy After Implantation of Ultrathin Sirolimus‐Eluting Stents With Biodegradable Polymer (Orsiro): Results From the SMART‐CHOICE Trial

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Kyeong Ho Yun ◽  
Seung‐Yul Lee ◽  
Byung Ryul Cho ◽  
Woo Jin Jang ◽  
Young Bin Song ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Biodegradable Polymer ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Target Vessel ◽  
Unique Identifier ◽  
P2y12 Inhibitor ◽  
Target Vessel Revascularization ◽  
Significant Difference ◽  
Post Hoc

Background This study sought to investigate the safety of 3‐month dual antiplatelet therapy (DAPT) in patients receiving ultrathin sirolimus‐eluting stents with biodegradable polymer (Orsiro). Methods and Results The SMART‐CHOICE (Smart Angioplasty Research Team: Comparison Between P2Y12 Antagonist Monotherapy vs Dual Anti‐ platelet Therapy in Patients Undergoing Implantation of Coronary Drug‐Eluting Stents) randomized trial compared 3‐month DAPT followed by P2Y12 inhibitor monotherapy with 12‐month DAPT in 2993 patients undergoing percutaneous coronary intervention. The present analysis was a prespecified subgroup analysis for patients receiving Orsiro stents. As a post hoc analysis, comparisons between Orsiro and everolimus‐eluting stents were also done among patients receiving 3‐month DAPT. Of 972 patients receiving Orsiro stents, 481 patients were randomly assigned to 3‐month DAPT and 491 to 12‐month DAPT. At 12 months, the target vessel failure, defined as a composite of cardiac death, target vessel–related myocardial infarction, or target vessel revascularization, occurred in 8 patients (1.7%) in the 3‐month DAPT group and in 14 patients (2.9%) in the 12‐month DAPT group (hazard ratio [HR], 0.58; 95% CI, 0.24–1.39; P =0.22). In whole population who were randomly assigned to receive 3‐month DAPT (n=1495), there was no significant difference in the target vessel failure between the Orsiro group and the everolimus‐eluting stent group (n=1014) (1.7% versus 1.8%; HR, 0.96; 95% CI, 0.41–2.22; P =0.92). Conclusions In patients receiving Orsiro stents, clinical outcomes at 1 year were similar between the 3‐month DAPT followed by P2Y12 inhibitor monotherapy and 12‐month DAPT strategies. With 3‐month DAPT, there was no significant difference in target vessel failure between Orsiro and everolimus‐eluting stents. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02079194.

scholarly journals Evaluation of P Dispersion and P Dispersion Recovery in Patients with Pseudoexfoliative Syndrome

2019 ◽  
Vol 4 (05) ◽  
Author(s):  
Cosgun Ayhan ◽  
Gunes Alper
Keyword(s):  
Outpatient Clinic ◽  
Stress Test ◽  
Wave Dispersion ◽  
P Wave ◽  
Control Group ◽  
Study Group ◽  
P Wave Dispersion ◽  
The Third ◽  
Significant Difference ◽  
The Difference

Background: Pseudoexfoliative syndrome (PEX) is an old-age disease characterized by the accumulation of fibril materials in both the eye and extraocular organs. PEX is associated with many morbid and mortal cardiovascular diseases. The aim of our study was to investigate the effects of the stress test on P Wave dispersion (PWD) in patients with PEX. Patients and Methods: Forty patients who presented to the ophthalmology outpatient clinic between February 2018 and September 2018 and diagnosed as PEX in the ophthalmologic examination were included in the study. As a control group, forty-four patients, age and gender-matched, who applied to the cardiology outpatient clinic, diagnosed in the outpatient clinic of ophthalmology non-PEX, were included in the study. The study and control group were subjected to treadmill exercise test (TET) according to Bruce protocol. Results: The recovery PWD value of the study group in the third minutes was 34.4 ±4.35 ms and rest PWD value of study group 32.925±5.17 ms. There was no statistically significant difference between the two values (t=1.37992, p=0.08). The basal PWD value of the control group was 31.79±3.9ms, the recovery PWD value of the control group in the second minute 32.65±3.48 ms. There was no statistically significant difference between the two values (t=1.09495, p=0.13). Conclusion: The most interesting result of the study was that the difference between the recovery PWD value and the resting PWD value in the study group was statistically insignificant in the third recovery minute, whereas in the control group it occurred in the second minute.

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.

Association of P-Wave Dispersion with Overall and Cardiovascular Mortality in Hemodialysis Patients

2015 ◽  
Vol 42 (3) ◽  
pp. 198-205 ◽  
Author(s):  
Szu-Chia Chen ◽  
Ho-Ming Su ◽  
Jiun-Chi Huang ◽  
Ko Chang ◽  
Yi-Chun Tsai ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Cox Regression ◽  
Wave Dispersion ◽  
Hemodialysis Patients ◽  
P Wave ◽  
P Wave Dispersion ◽  
Cox Regression Analysis ◽  
Atrial Enlargement ◽  
The Mean

Background/Aims: The P-wave parameters that are measured using a 12-lead electrocardiogram are commonly used as noninvasive tools for assessing left atrial enlargement. This study was designed to assess whether P-wave dispersion is associated with overall and cardiovascular mortality in hemodialysis patients. Methods: This study enrolled 209 hemodialysis patients. We measured the P-wave dispersion corrected by heart rate, that is, the corrected P-wave dispersion (PWdisperC), and assessed its correlation with overall and cardiovascular mortalities. Results: The mean PWdisperC of all the patients was 93.3 ± 21.1 ms. During the follow-up period (mean 5.4 years), 58 deaths and 37 cardiovascular deaths were recorded. The adjusted value of PWdisperC was also associated with overall (hazards ratio (HR) 1.018, 95% CI 1.004-1.033, p = 0.014) and cardiovascular (HR 1.032, 95% CI 1.012-1.053, p = 0.002) mortalities. Multivariate Cox regression analysis identified tertile 3 of PWdisperC (vs. tertile 1) to be associated with overall (HR 2.472, 95% CI 1.181-5.174, p = 0.016) and cardiovascular (HR 3.896, 95% CI 1.463-10.376, p = 0.007) mortalities, after adjustment for demographic, clinical and biochemical parameters. Adding PWdisperC to a model of clinical features could significantly improve the predictive value for overall (p = 0.044) and cardiovascular (p = 0.002) mortalities. Conclusions: We concluded that PWdisperC was positively associated with overall and cardiovascular mortalities in hemodialysis patients and could provide additional prognostic values. Screening hemodialysis patients by using PWdisperC may facilitate identifying a group of patients with poor prognosis.

Sign in / Sign up

Export Citation Format

Share Document