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.

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.

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

Assessment of P-wave dispersion in children with atrial septal aneurysm

2013 ◽  
Vol 24 (5) ◽  
pp. 918-922 ◽  
Author(s):  
Derya Arslan ◽  
Derya Cimen ◽  
Osman Guvenc ◽  
Bulent Oran ◽  
Fatma Hilal Yilmaz
Keyword(s):  
Wave Dispersion ◽  
P Wave ◽  
Controlled Study ◽  
Control Group ◽  
Atrial Septal Aneurysm ◽  
P Wave Dispersion ◽  
Wave Duration ◽  
P Wave Duration ◽  
Significant Difference ◽  
Echocardiographic Parameters

AbstractBackgroundThis was a prospective controlled study to determine the P-wave duration and P-wave dispersion in patients with atrial septal aneurysm.MethodsA total of 41 children with atrial septal aneurysm, including 21 boys and 20 girls (mean age 11.85 ± 3.8 years), and 32 controls, including 17 boys and 15 girls (mean age 12.3 ± 2.9 years), were included. P-wave dispersion was calculated from the 12-lead electrocardiogram. Cardiac functions, morphology of the aneurysm, and left atrial diameter were measured using conventional echocardiography. The diagnosis of atrial septal aneurysm was made when the base of the aneurysms with an excursion ratio ≥25% was found on echocardiography.ResultsThere was no significant difference between the patient and control groups in demographic, clinical findings, and M-mode echocardiographic parameters. The P-wave dispersion in patients with atrial septal aneurysm was significantly longer compared with the control group (64.4 ± 13.4 ms; p < 0.0001). Similarly, the the maximum duration of the P wave in the patient group was significantly longer compared with the control group (106.1 ± 13.3 ms; p < 0.001). The P-wave duration and dispersion were not correlated with age, gender, systolic and diastolic blood pressure, or m-mode echocardiographic parameters.ConclusionsThis study shows that P-wave dispersion is delayed in atrial septal aneurysm patients. Prolonged P-wave dispersion was determined to indicate electrical disturbance, and therefore it has an increased electrocardiographic risk of atrial arrhythmia in children with atrial septal aneurysm.

scholarly journals Frequency-Following Response (FFR) in Military Pilots

2020 ◽  
Author(s):  
Graziela Maria Martins-Moreira ◽  
Alessandra Spada Durante
Keyword(s):  
Pure Tone Audiometry ◽  
Control Group ◽  
Study Group ◽  
Aircraft Accidents ◽  
Frequency Following Response ◽  
Significant Difference ◽  
Qualitative Variables ◽  
Chi Squared ◽  
The Right ◽  
Military Pilots

Abstract Introduction Good hearing in pilots, including central auditory skills, is critical for flight safety and the prevention of aircraft accidents. Pure tone audiometry alone may not be enough to assess hearing in the members of this population who, in addition to high noise levels, routinely face speech recognition tasks in non-ideal conditions. Objective To characterize the frequency-following response (FFR) of a group of military pilots compared with a control group. Methods Twenty military pilots in the Study Group and 20 non-pilot military personnel, not exposed to noise in their work, in the Control Group, all with normal hearing, aged between 30 and 40 years old, completed a questionnaire to assess their hearing habits, and their FFRs were measured with a /da/ syllable (duration 40 milliseconds, speed 10.9/s), at 80 dB NA in the right ear. All procedures were approved by the ethical committee of the institution. Statistical analysis was performed using the t-Student or Mann-Whitney tests for quantitative variables, and the Fisher or chi-squared tests for qualitative variables, and a value of p < 0.05 was considered to be statistically significant. Results There was no significant difference between the groups regarding auditory habits. In the FFR, wave amplitudes A (p = 0.01) and C (p = 0.04) were significantly lower in the Study Group. Conclusion Working as a military pilot can be a crucial factor in determining an individual's typical FFR pattern, demonstrated in the present study by statistically significant reductions in the amplitudes of the A and C waves.

RISK PREDICTION FOR ARRHYTHMIA IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2021 ◽  
Vol 74 (10) ◽  
pp. 2605-2609
Author(s):  
Tetyana M. Ternushchak ◽  
Marianna I. Tovt-Korshynska
Keyword(s):  
P Wave ◽  
Doppler Imaging ◽  
Control Group ◽  
Chronic Obstructive ◽  
Conduction Time ◽  
Electromechanical Delay ◽  
P Wave Dispersion ◽  
Atrial Electromechanical Delay ◽  
Copd Patients ◽  
Significant Difference

The aim: To evaluate P-wave dispersion (PwD), as an independent predictor of atrial fibrillation, corrected QT interval dispersion (cQTD), the noninvasive marker of ventricular arrhythmia and sudden cardiac death, investigate the atrial electromechanical delay in patients with COPD and assess their relation with the severity of the disease. Materials and methods: We prospectively enrolled consecutive patients with newly diagnosed COPD (n = 53, age 41.2 ± 6.8 years), compared with an age-matched healthy control group (n = 51, age 40.9 ± 6.5 years). A standard 12-lead electrocardiogram of each patient was analyzed for PwD and сQTD. Atrial electromechanical delay was analyzed by echocardiographic tissue Doppler imaging. The difference between PAs-PAl, PAs-PAt, and PAl-PAt were defined as left intra-atrial, right intra-atrial, and interatrial electromechanical delays (EMD), respectively. Results: PwD was higher in COPD patients than in control subjects (39.47 ± 3.12 ms vs. 30.29 ± 3.17 ms, p < 0.05). In comparison between control group and COPD subgroups (mild, moderate and severe), there was a statistically significant difference among these free groups in terms of PwD. Subgroup analyses showed that this difference was mainly due to patients with severe COPD. Regarding cQTD, there was a statistically significant increase in COPD patients 57.92 ± 3.43 ms vs 41.03 ± 5.21 ms, p < 0.05 respectively. PAs, PAl and PAt durations, right intra-atrial and interatrial EMD were also significantly longer in COPD patients (p < 0.05). Furthermore, there were significant negative correlations between FEV1 and PwD (r = – 0.46, p < 0.05), right intra-atrial (r = – 0.39 ms, p < 0.05), interatrial EMD ( r = – 0.35 ms, p < 0.05) and cQTD (r = – 0.32, p < 0.05). Conclusions: Atrial conduction time, such as inter- and intra-atrial EMD intervals, PwD and cQTD were longer than in healthy controls and correlated with the severity of COPD. These parameters offer a non-invasive and cost-effective assessment method for detecting patients at high risk of arrhythmia. Nevertheless, further prospective investigations on this issue are required.

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.

P wave dispersion, Tpeak–Tend interval, and Tp-e/QT ratio in children with psoriasis

2020 ◽  
Vol 30 (3) ◽  
pp. 318-322
Author(s):  
Mecnun Çetin ◽  
İbrahim H. Yavuz ◽  
Mehmet Gümüştaş ◽  
Göknur Ö. Yavuz
Keyword(s):  
Wave Dispersion ◽  
P Wave ◽  
Cardiac Conduction ◽  
Control Group ◽  
Healthy Children ◽  
P Wave Dispersion ◽  
System Disease ◽  
Increased Risk ◽  
Electrocardiographic Parameters ◽  
Key Indicators

AbstractBackground:Psoriasis is a chronic inflammatory, multi-system disease that often begins in childhood and characterised by inflammatory skin, nails, scalp, and joint manifestations. The inflammation in psoriasis may promote some effect on the cardiac conduction system.Objective:The aim of this study is to investigate myocardial repolarisation anomaly on the conducting system in the paediatric psoriasis using P wave dispersion, Tpeak–Tend interval, and Tp-e/QT ratio.Methods:Forty-two patients diagnosed with psoriasis and 37 age- and sex-matched healthy children were enrolled in the study. Electrocardiographic parameters in psoriasis and control group were recorded from an electrocardiogram for each patient.Results:The results indicated that the parameters including Pdis, QTc dis, Tp-e dis interval, and Tp-e max/QTmax ratios, which are known to be key indicators for the prediction of severe atrial or ventricular arrhythmia and sudden cardiac death and also important parameters used as the indicators for the non-invasive evaluation of the transmural heterogeneity were significantly longer in the study group compared to the control group (p < 0.05).Conclusions:This study includes the evidence linking psoriasis with increased myocardial repolarisation heterogeneity. These findings suggest that this patient population may be at an increased risk for arrhythmias. Our findings may be a basis for further studies.

Increased QT and P-wave dispersion during attack-free period in pediatric patients with migraine attacks

2019 ◽  
Vol 29 (4) ◽  
pp. 488-491
Author(s):  
Oyku Tosun ◽  
Elif Karatoprak
Keyword(s):  
Wave Dispersion ◽  
P Wave ◽  
Sympathetic System ◽  
Control Group ◽  
Qtc Interval ◽  
Control Groups ◽  
P Wave Dispersion ◽  
Surface Ecg ◽  
Migraine Group ◽  
And Control

AbstractIntroduction:Migraine is a common neurovascular disease characterised with recurrent attacks by pain-free periods. It has been suggested that both sympathetic and parasympathetic dysfunctions play a role in its pathophysiology.Aim:The aim of our study was to investigate the ECG changes during attack-free period in children with migraine, in terms of QTc interval, QTc, and P-wave dispersion to evaluate the autonomic nervous system disturbance.Methods:Sixty children who were diagnosed with migraine were included as patient group and 50 healthy, age- and body mass index-matched children who were examined for innocent murmur were included as control group. The patients’ routine ECG records were screened from the outpatient clinic files. The durations of P-wave, QT, and QTc intervals and dispersion values and heart rates (beats/minute) were compared between the patient and control groups.Results:P maximum and P dispersion were significantly higher, and P minimum was significantly lower in the migraine group compared with the control group. QT–QTc maximum and QT–QTc dispersion were significantly higher and QT–QTc minimum was significantly lower in the migraine group compared with the control group.Conclusion:According to our findings, although migraine patients were asymptomatic and no arrhythmia was detected in the surface ECG, sympathovagal balance in the sympathetic system, which may be disrupted in favour of the sympathetic system, should continue even in the attack-free period, and we should be careful in terms of serious arrhythmias that may develop in these patients.

How valuable is P-wave dispersion in the determination of carboxyhemoglobin levels?

2013 ◽  
Vol 33 (5) ◽  
pp. 466-472
Author(s):  
MT Sener ◽  
Y Anci ◽  
K Kalkan ◽  
MZ Kir ◽  
M Emet
Keyword(s):  
Roc Curve ◽  
Predictive Value ◽  
Complete Blood Count ◽  
Wave Dispersion ◽  
P Wave ◽  
Control Group ◽  
Co Poisoning ◽  
P Wave Dispersion ◽  
Cohb Level ◽  
Positive Correlations

Objective: To determine whether or not wave/interval dispersions in electrocardiography (ECG) are increased, and to define whether wave and interval dispersions are correlated with carboxyhemoglobin (COHb) levels. Methods: ECG, complete blood count, and biochemical parameters were taken from 87 patients with carbon monoxide (CO) poisoning as well as 90 control patients with similar age, gender, and body mass index distribution. COHb levels were recorded in CO-poisoning patients. The COHb levels and the relationships with ECG parameters were studied. Results: Pmax, Pmin, Pd, PRmax, PRmin, PRd, QTmax, QTmin, QTd, cQTmax, cQTmin, cQTd, Tmax, Tmin, and Td in ECG were higher in intoxicated patients than the control group ( p < 0.05 for all). Pearson’s correlation analyses showed moderately significant positive correlations between COHb level and Pmax ( r = 0.224; p = 0.037) and Pd ( r = 0.222; p = 0.039). The receiver–operator characteristic (ROC) curve showed that a Pd value of 38 ms determined by ECG separates patients with a COHb ≥ 20% with area under the ROC curve of 0.78 (95%CI = 0.71–0.83), a sensitivity of 67.9% (95%CI = 59.4–75.6), a specificity of 95% (95%CI = 83.0–99.2], a positive predictive value of 97.9% (95%CI = 92.5–99.7), and a negative predictive value of 46.3% (95%CI = 35.3–57.7.) Conclusion: A significant increase in wave/interval dispersions in the ECG of CO-poisoning patients compared with controls may show that not only a part is affected but both atrium and the ventricles as a whole are affected by hypoxic ischemia. When COHb levels of the patients are unavailable, P dispersion on ECG may show CO poisoning level of the patient.

scholarly journals Effect of Coronary Slow Flow on Intrinsicoid Deflection of QRS Complex

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Sabri Seyis
Keyword(s):  
Wave Dispersion ◽  
Left Ventricular ◽  
P Wave ◽  
Control Group ◽  
Slow Flow ◽  
Pathophysiological Mechanism ◽  
P Wave Dispersion ◽  
Benign Condition ◽  
Coronary Syndrome ◽  
Coronary Slow Flow

Coronary slow flow is a rare, clinically important entity observed in acute coronary syndrome. The pathophysiological mechanism is not fully elucidated. We investigated patients with chest pain who had angiographic features consistent with the coronary slow flow. One hundred ten patients were included. Electrocardiography, echocardiography, and angiography results were retrospectively noted. The mean age was 56.4. Fifty-eight were male, and fifty-two were female. The control group consisted of patients with normal angiography. Patients had higher diastolic blood pressure, lower mean ejection fraction, higher average left ventricular end-diastolic diameter, and higher mean left atrial size than the control group (p=0.009,p=0.017,p=0.041,andp<0.001, resp.). Patients had higher average V1 ID, V6 ID, P wave dispersion, TFC LAD, TFC Cx, TFC RCA, and TFC levels than the control group. A significant linear positive relationship was found between the V1 ID and the TFC LAD, TFC Cx, TFC RCA, and TFC; also between the V6 ID and the TFC LAD, TFC Cx, TFC RCA, and TFC. Angiographic and electrocardiographic features are suggestive and diagnostic for the coronary slow flow syndrome. Although when regarded as a benign condition, coronary slow flow should be diagnosed, followed up, and treated as many of laboratory features suggest ischemic events.

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