title: The impact of left atrial pressure on filtered P-wave duration in patients with atrial fibrillation.
abstract: The cause of prolonged filtered P-wave duration (FPD) remains unclear in atrial fibrillation (AF) patients with normal left atrial size. We investigated whether FPD is associated with left atrial pressure (LAP) in AF patients without prominent LA enlargement. This study included 80 patients (48 men, age 65 ± 9 years, 25 persistent AF) with non-valvular AF who underwent catheter ablation (CA) for AF. LAP was measured in sinus rhythm during CA and signal-averaged electrocardiogram was recorded after CA. We retrospectively assessed the clinical and echocardiographic variables. Prolonged FPD was defined as FPD > 120 ms. Prolonged FPD (FPD > 120 ms) was detected in 23/80 patients (29 %). According to univariate analysis, higher mean LAP (14.9 ± 4.4 vs. 10.8 ± 3.5 mmHg, p < 0.0001), higher prevalence of persistent arrhythmia, higher BNP, larger LAD, higher E wave, and lower LVEF were associated with Prolonged FPD. According to multivariate analysis, higher mean LAP was the only factor associated with Prolonged FPD (p = 0.0058, OR 1.256 for each 1 mmHg increase in mean LAP, 95 % CI 1.068-1.476). Moreover, a significant correlation was observed between FPD and mean LAP (r = 0.503, p < 0.0001). Prolonged FPD is associated with high LAP in AF patients without prominent left atrial enlargement. Pressure overload of the left atria might cause slowing of atrial electrical activation.
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan. kishima@hyo-med.ac.jp.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kishima
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.
authors.forename: Takanao
authors.initials: T
authors.lastname: Mine
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.
authors.forename: Kenki
authors.initials: K
authors.lastname: Ashida
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ishihara
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Masuyama
mesh_terms: D000200:Action Potentials; D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery; D016279:Atrial Function, Left; D062185:Atrial Pressure; D017115:Catheter Ablation; D016009:Chi-Square Distribution; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology* / Q000601:surgery; D006339:Heart Rate; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: Atrial fibrillation; Filtered P-wave duration; Left atrial pressure