Open AccessThe Value of P Dispersion on Predicting Atrial Fibrillation After Coronary Artery Bypass Surgery: Effect of Magnesium on P Dispersion
Author(s) -
Dagdelen Sinan,
Toraman Fevzi,
Karabulut Hasan,
Alhan Cem
Publication year - 2002
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/j.1542-474x.2002.tb00165.x
Subject(s) - medicine , atrial fibrillation , cardiology , qrs complex , coronary artery disease , artery , magnesium , dispersion (optics) , anesthesia , surgery , materials science , physics , optics , metallurgy
Background: AF is a frequent arrhythmia complicating CABG, and it is well known that dispersion and prolongation of P wave increases the risk of AF. The aim of this study was to investigate the effect of magnesium (Mg) treatment on P‐wave duration and dispersion in patients undergoing CABG. Method: The study included 148 consecutive patients (33 women, 115 men; mean age 62.1 ± 7.0 years) undergoing CABG who were randomly allocated to two groups. Group A consisted of 93 patients to whom 1.5 g daily MgSO 4 infusion was applied the day before surgery, just after operation, and 4 days following surgery, and group B consisted of 55 control patients. From the preoperative and postoperative fourth day, 12‐lead ECG recordings, duration of the P waves, and P‐wave dispersions were calculated. Results: There were no differences between the two groups with regard to age, sex, and blood Mg level. Comparison of the baseline and day 4 ECG measurements showed no difference as far as heart rates, duration of PQ, and QRS intervals were concerned. AF developed in 2 (2%) cases in group A and in 20 (36%) cases in group B (P < 0.001). There was no difference between the two groups when average basal P max, P min, P dispersion, and day 4 P min values were compared. In group A, fourth day P max (94.3 ± 11.8 vs 101.0 ± 13.2 ms; P = 0.0025) and P dispersion (38.2 ± 9.2 vs 44.9 ± 10.9 ms; P = 0.0002) were significantly lower as compared to group B. Comparing the patients who developed AF, and who did not, no difference was detected with regard to baseline P max, P min, P dispersion, and day 4 P min. Day 4 P max (95.1 ± 11.8 vs 106.4 ± 14.0 ms, P = 0.0015) and P dispersion (38.9 ± 8.8 vs 50.7 ± 13.0 ms, P = 0.001) of patients who developed AF were significantly higher. Baseline Mg levels were similar in patients who developed AF, and who did not, but the day 4 Mg level was significantly lower in AF group (2.0 ± 0.23 vs 2.15 ± 0.26 mg/dL, P < 0.001). Conclusion: Perioperative Mg treatment reduces P dispersion and the risk of developing AF in patients undergoing CABG. A.N.E. 2002;7(3):211–218