P wave dispersion in hypertensive patients with paroxysmal atrial fibrillation.
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.
Ozer
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N
Department of Cardiology, School of Medicine, Hacettepe University, Ankara, Turkey. neozer@hacettepe.edu.tr
Aytemir
K
K
Atalar
E
E
Sade
E
E
Aksöyek
S
S
Ovünç
K
K
Açýl
T
T
Nazlý
N
N
Ozmen
F
F
Oto
A
A
Kes
S
S
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D016279:Atrial Function, Left; D002302:Cardiac Output; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016277:Ventricular Function, Left