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P Wave Dispersion in Hypertensive Patients with Paroxysmal Atrial Fibrillation
Author(s) -
ÖZER NECLA,
AYTEMIR KUDRET,
ATALAR ENVER,
SADE ELIF,
AKSÖYEK SERDAR,
ÖVÜNç KENAN,
AçÝL TAYFUN,
NAZLÝ NASÝH,
ÖZMEN FERHAN,
OTO ALI,
KES SÝRRÝ
Publication year - 2000
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2000.tb07038.x
Subject(s) - medicine , atrial fibrillation , ejection fraction , cardiology , sinus rhythm , paroxysmal atrial fibrillation , electrocardiography , heart failure
It is important to assess the risk of developing paroxysmal atrial fibrillation (PAF) in hypertensive patients since hypertension is a common disorder predisposing to PAF. We sought to determine if patients with hypertension at risk of PAF can be identified while in sinus rhythm by measurements of P wave dispersion. Twelve‐lead surface electrocardiograms were recorded in 44 hypertensive patients with history of PAF (group I, mean age = 60) and in 50 hypertensive patients without history of AF (group II, mean age = 57). The maximum P wave duration, the minimum P wave duration, and P wave dispersion (Pd = Pmax ‐Pmin) were calculated from 12‐lead surface ECGs. Left atrial dimension (LAD) and left ventricular ejection fraction (LVEF) were measured by echocardiography. P wave dispersion was significantly greater in group I than group II (50 ± 12 vs 38 ± 8 ms, P = 0.001). P minimum (75 ± 13 vs 87 ± 11 ms, P = 0.001) and LVEF (0.63 ± 0.05 vs 0.67 ± 0.04, P = 0.03) were significantly lower in group I than group II. However P maximum and LAD were not significantly different in group I than group II (P > 0.05). In univariate analysis, P minimum, P wave dispersion, and LVEF were significant predictors of PAF, whereas only P wave dispersion remained a significant independent predictor of PAF in a multivariate analysis. Measurement of P wave dispersion in sinus rhythm may be a useful noninvasive clinical tool to identify patients with hypertension at risk of developing atrial electrical instability and atrial fibrillation.