Improvement of P wave dispersion after cardiac resynchronization therapy for heart failure.
OBJECTIVE
The purpose of this study is to investigate the effect of cardiac resynchronization therapy (CRT) on P wave maximum duration (PWM) and P wave dispersion (PWD) in patients with advanced heart failure.


METHODS
Forty-six patients (33 men; mean age, 60 +/- 11 years) with CRT were enrolled in the present study. PWM and PWD were measured using 12-lead surface electrocardiography (ECG) at a paper speed of 50 mm/s and 20 mm/mV. Serial ECG, echocardiography, clinical assessment, and device interrogations were performed at baseline and 3 months after CRT.


RESULTS
After 3 months of follow-up, PWM and PWD values were significantly decreased (129.6 +/- 11.3 to 120.7 +/- 10.7 milliseconds, P < .001; 42.6 +/- 8.0 to 32.3 +/- 10.1 milliseconds; P < .001, respectively). It showed a significant reduction in left atrial diameter (LAD) (46.5 +/- 5.2 to 44.9 +/- 5.6 mm, P = .021) and an improvement in left ventricular ejection fraction (LVEF) (29.0% +/- 7.5% to 36.2% +/- 8.0%, P < .001). The decrease of PWM and PWD was positively correlated with the reduction of LAD and negatively correlated with the improvement of LVEF. The reduction in atrial fibrillation burden was observed after 3 months of follow-up.


CONCLUSIONS
Cardiac resynchronization therapy decreases PWM and PWD along with an improvement of LVEF and a reduction of LAD. Further studies are needed to evaluate the clinical implications of decrease of PWD on prevention of atrial fibrillation.
Ding
Ligang
L
Center of Arrhythmia Diagnosis and Treatment, Fuwai Hospital and Cardiovascular Institute, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Hua
Wei
W
Zhang
Shu
S
Chu
Jianmin
J
Chen
Keping
K
Wang
Fangzheng
F
Chen
Xin
X
D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome