title: P-wave dispersion by 12-lead electrocardiography in carotid artery stenting.
abstract: OBJECTIVE
  Although carotid artery stenting (CAS) is an effective treatment for severe carotid stenosis, it has been associated with alterations in autonomic functions during or shortly after the procedure. And, autonomic functions influence P-wave durations. In this study, our aim was to investigate P-wave durations on 12-lead surface electrocardiography after CAS.
  
  
  METHODS
  Patients (19 male, 8 female) who are suitable for CAS, without a history of hypertension, diabetes mellitus, severe coronary artery or valvular heart disease, were enrolled in our study. 12-lead surface electrocardiography recordings were obtained at the beginning, immediately after and at the 24 h of the procedure. P-wave maximum, minimum and dispersion durations were analyzed by double-blinded observers. Results were statistically analysed using Friedman and Wilcoxon tests.
  
  
  RESULTS
  The P maximum and P dispersion values were significantly increased immediately after the procedure and continued with high levels at 24-h recordings, respectively (128 ± 10/19 ± 7, 143 ± 14/37 ± 11, and 137 ± 11/30 ± 7 ms, p value <0.05). The P minimum value was significantly decreased immediately after the procedure (109 ± 11/105 ± 10 ms, p value <0.05). At 24-h recordings, a nonsignificant increase occured in P minimum values (106 ± 8 ms).
  
  
  CONCLUSIONS
  P maximum and dispersion durations were significantly increased after the CAS and continued with high levels at 24-h recordings, which may be associated with the alterations in autonomic functions via augmented parasympathetic activity by vagally mediated stimulus. Overall, these findings suggest that decline in cardiovascular activity is prolonged at least 24 h after CAS.
authors.affiliation: Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Education and Research Hospital, Istanbul, Turkey. gokhanalici@yahoo.com
authors.forename: Gokhan
authors.initials: G
authors.lastname: Alici
authors.forename: Birol
authors.initials: B
authors.lastname: Ozkan
authors.forename: Mehmet Vefik
authors.initials: MV
authors.lastname: Yazicioglu
authors.forename: Muslum
authors.initials: M
authors.lastname: Sahin
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bulut
authors.forename: Goksel
authors.initials: G
authors.lastname: Acar
authors.forename: Osman Gazi
authors.initials: OG
authors.lastname: Kiraz
authors.forename: Ali Metin
authors.initials: AM
authors.lastname: Esen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000601:surgery*; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects*