P wave dispersion and P wave duration on SAECG in predicting atrial fibrillation in patients with acute myocardial infarction.
BACKGROUND
Atrial fibrillation (AF) is a frequent complication of acute myocardial infarction (AMI), with reported incidence of 7% to 18%. The incidence of congestive heart failure, in-hospital mortality, and long-term mortality is higher in AMI patients with AF than in AMI patients without AF. P wave duration on signal-averaged ECG (PWD) and P wave dispersion on standard ECG (Pd) are noninvasive markers of intra-atrial conduction disturbances, which are believed to be the main electrophysiological cause of AF.


METHODS
In the present study we investigated prospectively whether P wave duration on SAECG and P wave dispersion on standard ECG can predict development of AF in a group of patients with AMI. One hundred and thirty patients (100 men and 30 women, aged 56.9 +/- 12) with AMI were investigated. PWD, Pd, their clinical and hemodynamic characteristics were collected.


RESULTS
During the observation up to 14 days, 22 patients (16.9%) developed AF. Univariate analysis variables associated with development of AF: age > 65 years, Killip class III-IV, PWD > 125 ms, and Pd > 25 ms. Stepwise logistic regression analysis showed that age > 65 years, PWD > 125 ms, and Pd > 25 ms were independently associated with AF.


CONCLUSIONS
PWD and Pd both measured in a very early period of AMI are useful in predicting AF.
Rosiak
Marcin
M
Department of Cardiology, Institute of Cardiology, Medical University of Lodz, Sterlinga 1/3, 91-425 Lodz, Poland.
Bolinska
Halina
H
Ruta
Jan
J
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000209:etiology; D017023:Coronary Angiography; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology; D011446:Prospective Studies; D012680:Sensitivity and Specificity