Duration and dispersion of the P wave after the Senning operation

Abstract

We studied the duration and dispersion of the P wave in patients after a Senning operation, assessing its value in detecting the risk of atrial tachycardias.We measured the duration and dispersion of the wave in surface 12 lead electrocardiograms obtained from 18 patients with sinus rhythm, having a mean age of 12.8 years, with 13 being males and 5 females, who had undergone a Senning operation, comparing the values obtained in 35 age and gender-matched healthy people. The patients had undergone repair at a mean age of 13.4 months, and had a mean duration of follow-up of 12.8 years after the procedure. We also made 24 hour Holter recordings.The maximal duration of the P wave, at a mean of 129.3 milliseconds, and dispersion with a mean of 78 milliseconds, were both significantly increased in the patients compared with their controls, the mean values for the normal subjects being 103.7 and 54 milliseconds. Supraventricular tachycardia was detected in 1 of 3 patients with dispersion greater than 100 milliseconds, and in 2 of 15 patients (13%) with dispersion less than 100 milliseconds as measured from the Holter recordings (p > 0.05).Thus, the maximum duration and dispersion of the P wave were increased in patients after a Senning operation, but we were unable to establish any relationship between these measurements and atrial tachycardias as observed using Holter monitoring.

Holter Electrocardiography Findings and P‐Wave Dispersion in Pediatric Patients with Transcatheter Closure of Atrial Septal Defects

“…An increase in P max and P dis values in comparison to healthy controls has been reported in patients who underwent surgery for various congenital heart defects. A correlation between atrial tachycardia and either Pmax or Pdis has been established in patients with Fallot's tetralogy following complete repair with the Fontan procedure; such a correlation was not found, however, in patients undergoing Senning's operation . We could not evaluate the correlation between arrhythmia and the P max or P dis values in this study because these values were not increased postprocedure.…”

“…It was measured for three consecutive beats on each derivation, and the average was calculated. P dis was defined as the difference between the longest and the shortest P distances . The P waves were measured by four investigators unaware of the subjects’ individual data.…”

“…Studies in children with ostium secundum ASDs found significantly increased Pdisperison (P dis ) and Pmaximum (P max ) values . Several reports indicated that a lengthening of P‐wave duration and an increase in P dis are risk factors for atrial fibrillation …”

Meta‐Analysis of P‐Wave Dispersion Values in Healthy Individuals: The Influence of Clinical Characteristics

“…1). 3 , 7–85 Fourteen of these articles utilized only a computer‐assisted technique for P‐wave evaluation.…”

Assessment of atrial electromechanical delay in children with acute rheumatic fever

“…Dispersion of the P-wave was calculated as the difference between the maximum and minimum P-wave durations. 17,18 An acceptable electrocardiogram was determined by its ability to measure P-wave duration in at least 8 of the 12 electrocardiographic leads recorded simultaneously.…”