title: Sinus and paced P wave duration and dispersion as predictors of atrial fibrillation after pacemaker implantation in patients with isolated sick sinus syndrome.
abstract: The aim of this study was to prospectively evaluate the sinus and the paced P wave duration and dispersion as predictors of AF after pacemaker implantation in patients with isolated sick sinus syndrome (SSS). The study included 109 (69 women, mean age 72 +/- 11 years) patients with SSS, 59 with bradycardia-tachycardia syndrome (BTS). A 12-lead ECG was recorded before pacemaker implantation and during high right atrial and septal right atrial pacing at 70 and 100 beats/min. The ECGs were scanned into a computer and analyzed on screen. The patients were treated with AAIR (n = 52) or DDDR pacing. The P wave duration was measured in each lead and mean P wave duration and P wave dispersion were calculated for each ECG. AF during follow-up was defined as: AF in an ECG at or between follow-up visits; an atrial high rate episode with a rate of > or =220 beats/min for > or =5 minutes, atrial sensing with a rate of > or =170 beats/min in > or =5% of total counted beats, mode-switching in >/=5% of total time recorded, or a mode switching episode of > or =5 minutes recorded by the pacemaker telemetry. The ECG parameters were correlated to AF during follow-up. Mean follow-up was 1.5 +/- 0.9 years. None of the ECG parameters differed between patients with AF and patients without AF during follow-up, nor was there any difference between groups after correction for BTS and age. BTS was the strongest predictor of AF during follow-up (P < 0.001). P wave duration and dispersion measured before and during pacemaker implantation were not predictive of AF after pacemaker implantation in patients with isolated SSS.
authors.affiliation: Department of Cardiology, Skejby Hospital, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Lene
authors.initials: L
authors.lastname: Kristensen
authors.forename: Jens Cosedis
authors.initials: JC
authors.lastname: Nielsen
authors.forename: Peter Thomas
authors.initials: PT
authors.lastname: Mortensen
authors.forename: Per Dahl
authors.initials: PD
authors.lastname: Christensen
authors.forename: Thomas
authors.initials: T
authors.lastname: Vesterlund
authors.forename: Anders Kirstein
authors.initials: AK
authors.lastname: Pedersen
authors.forename: Henning Rud
authors.initials: HR
authors.lastname: Andersen
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012044:Regression Analysis; D012804:Sick Sinus Syndrome / Q000150:complications / Q000503:physiopathology* / Q000628:therapy