title: Signal-averaged P wave duration and the long-term risk of permanent atrial fibrillation.
abstract: OBJECTIVE
  To assess the long-term risk of developing permanent AF in relation to the signal-averaged P wave duration (SAPWD) and clinical and echocardiographic characteristics.
  
  
  METHODS
  In an observational study design we studied 131 patients with earlier ECG-documented AF and successfully restored sinus rhythm attending a long-term, follow-up visit at hospital or at home. Established permanent AF was examined in relation to primary clinical, echocardiographic, and electrophysiological parameters.
  
  
  RESULTS
  Only prolonged SAPWD (p=0.006) was associated with an increased risk of development of permanent AF. The risk of permanent AF after 3 years follow-up was 0.72 with an SAPWD equal to 180 ms versus 0.39 with a normal SAPWD (130 ms). We found no prognostic effect of age, gender, dilated left atrium, long duration of AF history, or long duration of the most recent episode of AF. Co-existing hypertension reduced the risk of permanent AF; this could be explained by concomitant treatment with angiotensin-converting-enzyme-inhibitors.
  
  
  CONCLUSIONS
  Prolonged SAPWD (a marker of atrial remodelling) appears to be a risk factor for long-term development of permanent AF.
authors.affiliation: Department of Cardiology, University Hospital of Gentofte, Copenhagen, Denmark. ulrikdixen@mail.dk
authors.forename: Ulrik
authors.initials: U
authors.lastname: Dixen
authors.forename: Mette Vang
authors.initials: MV
authors.lastname: Larsen
authors.forename: Lasse
authors.initials: L
authors.lastname: Ravn
authors.forename: Jan
authors.initials: J
authors.lastname: Parner
authors.forename: Gorm B
authors.initials: GB
authors.lastname: Jensen
mesh_terms: D000200:Action Potentials; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D004554:Electric Countershock; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012042:Registries; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors