Open AccessVariable Interatrial Conduction Illustrated in a Hypertrophic Cardiomyopathy Population
Author(s) -
Holmqvist Fredrik,
Platonov Pyotr G.,
Carlson Jonas,
Havmöller Rasmus,
Waktare Johan E.P.,
McKenna William J.,
Olsson S. Bertil,
Meurling Carl J.
Publication year - 2007
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.2007.00166.x
Subject(s) - medicine , cardiology , hypertrophic cardiomyopathy , atrial fibrillation , population , environmental health
Background: Patients with hypertrophic cardiomyopathy (HCM) have a high incidence of atrial fibrillation. They also have a longer P‐wave duration than healthy controls, indicating conduction alterations. Previous studies have demonstrated orthogonal P‐wave morphology alterations in patients with paroxysmal atrial fibrillation. In the present study, the P‐wave morphology of patients with HCM was compared with that of matched controls in order to explore the nature of the atrial conduction alterations. Methods and Results: A total of 65 patients (45 men, mean age 49 ± 15) with HCM were included. The control population (n = 65) was age and gender matched (45 men, mean age 49 ± 15). Five minutes of 12‐lead ECG was recorded. The data were subsequently transformed to orthogonal lead data, and unfiltered signal‐averaged P‐wave analysis was performed. The P‐wave duration was longer in the HCM patients compared to the controls (149 ± 22 vs 130 ± 16 ms, P < 0.0001). Examination of the P‐wave morphology demonstrated changes in conduction patterns compatible with interatrial conduction block of varying severity in both groups, but a higher degree of interatrial block seen in the HCM population. These changes were most prominent in the Leads Y and Z. Conclusion: The present study suggests that the longer P‐wave duration observed in HCM patients may be explained by a higher prevalence of block in one or more of the interatrial conduction routes.