title: Increased p-wave duration and p-wave dispersion in patients with aortic stenosis.
abstract: BACKGROUND
  P-wave dispersion (PWD), defined as the difference between the maximum and minimum P-wave duration, has been proposed as being useful for the prediction of paroxysmal atrial fibrillation (AF). AF is the most common arrhythmia and an important prognostic indicator for clinical deterioration in patients with aortic stenosis (AS). The aim of the present study was to evaluate PWD in patients with AS.
  
  
  METHODS
  The study population consisted of two groups: Group I consisted of 98 patients with AS (76 men, 22 women; aged 63 +/- 8 years) and group II consisted of 98 healthy subjects (same age and sex) without any cardiovascular disease. A 12-lead electrocardiogram was recorded for each subject. The P-wave duration was calculated in all leads of the surface electrocardiogram. The difference between the maximum and minimum P-wave duration was calculated and was defined as the PWD. All patients and control subjects were also evaluated by echocardiography to measure the left atrial diameter, left ventricular ejection fraction, left ventricular wall thicknesses, and the maximum and mean aortic gradients. Patients were also evaluated for the presence of paroxysmal AF.
  
  
  RESULTS
  Maximum P-wave duration and PWD of group I were found to be significantly higher than those of group II. In addition, patients with paroxysmal AF had significantly higher PWD than those without paroxysmal AF. There was no significant difference between the two groups regarding minimum P-wave duration. In addition, there was no significant correlation between echocardiographic variables and PWD.
  
  
  CONCLUSIONS
  PWD, indicating increased risk for paroxysmal AF, was found to be significantly higher in patients with AS than in those without it. Further assessment of the clinical utility of PWD for the prediction of paroxysmal AF in patients with severe AS will require longer prospective studies.
authors.affiliation: Turkiye Yuksek Ihtisas Hospital, Department of Cardiology, Ankara, Turkey. drhturhan@yahoo.com
authors.forename: Hasan
authors.initials: H
authors.lastname: Turhan
authors.forename: Ertan
authors.initials: E
authors.lastname: Yetkin
authors.forename: Ramazan
authors.initials: R
authors.lastname: Atak
authors.forename: Tayfun
authors.initials: T
authors.lastname: Altinok
authors.forename: Kubilay
authors.initials: K
authors.lastname: Senen
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ileri
authors.forename: Hatice
authors.initials: H
authors.lastname: Sasmaz
authors.forename: Sengul
authors.initials: S
authors.lastname: Cehreli
authors.forename: Emine
authors.initials: E
authors.lastname: Kutuk
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged