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


METHODS
In the present study we investigated whether PWD can predict development of AF in 130 AMI patients (100 men and 30 women, aged 56.9+/-12). PWD was recorded, along with clinical and hemodynamic characteristics.


RESULTS
During the observation period (up to 21 days) 22 patients (16.9%) developed AF. In univariate analysis the variables associated with development of AF were age>65, Killip class III-IV, and PWD>125 ms. Stepwise logistic regression analysis showed that age>65 and PWD>125 ms were independently associated with AF.


CONCLUSIONS
PWD measured in a very early period of AMI is a useful tool in predicting AF.
Rosiak
Marcin
M
Department of Cardiology, Institute of Cardiology, Medical University, Łódź, Poland.
Ruta
Jan
J
Bolińska
Halina
H
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012815:Signal Processing, Computer-Assisted