Effect of left atrial size and function on P‐wave dispersion: A study in patients with paroxysmal atrial fibrillation

Tüukek, Tufan; Akkaya, Vakur; Atılgan, Dursun; Demirel, Şeref; Özcan, Mustafa; Güuven, Özen; Korkut, Ferruh

doi:10.1002/clc.4960241008

Cited by 49 publications

(44 citation statements)

References 15 publications

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“…Interobserver variability was 3 ± 4% and intraobserver variability was 1 ± 3%. It has been reported that P max and PD are associated with age, 28 left ventricular systolic function, 29 left atrium size 30 and increased sympathetic activity. 31 In our study there was no significant difference between the two groups in terms of these measures.…”

Section: Discussionmentioning

confidence: 99%

Effect of Ongoing Inflammation in Rheumatoid Arthritis on P-Wave Dispersion

et al. 2007

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It has been emphasized recently that there is a strong association between atrial fibrillation and inflammation. Rheumatoid arthritis (RA), characterized by ongoing inflammatory activity, can increase the risk of atrial arrhythmia. P-wave dispersion has been encountered as a risk factor for atrial fibrillation and the effect of inflammation on P-wave dispersion has not been studied thoroughly. The aim of this study was to examine the effect of ongoing inflammatory activity in RA on P-wave dispersion. The study comprised 82 patients diagnosed with RA and 41 healthy volunteers as controls. Systolic functions of all participants were evaluated by echocardiography. Maximum P-wave duration and dispersion were calculated and found to be significantly increased in the RA group compared with the healthy controls. These parameters were also significantly correlated with C-reactive protein levels. The findings of this study suggest that RA may be associated with increases in P-wave dispersion and maximum P-wave duration, and that this association may result from ongoing inflammation.

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Section: Discussionmentioning

confidence: 99%

Effect of Ongoing Inflammation in Rheumatoid Arthritis on P-Wave Dispersion

et al. 2007

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“…Bu elektrofizyolojik özelliklerin, yüzey EKG'ye, P dalga süresinin uzaması ve PDD' nun artması şeklinde yansıdığı düşünülmektedir (19). Sol atriyal volüm değiş-kenliğinin de PDD' na neden olabileceği bilinmektedir (20). Atriyal aritmileri, özellikle paroksismal AF' yi öngörmek için PDD' nin kullanılabileceği bildirilmiştir (19)(20)(21).…”

Section: Discussionunclassified

“…Sol atriyal volüm değiş-kenliğinin de PDD' na neden olabileceği bilinmektedir (20). Atriyal aritmileri, özellikle paroksismal AF' yi öngörmek için PDD' nin kullanılabileceği bildirilmiştir (19)(20)(21). Bu tekniğin değişik hasta popülasyonlarında AF öngörücüsü olarak kullanılabilece-ğine ait birçok yayın vardır.…”

Section: Discussionunclassified

Value of interatrial conduction time and P wave dispersion in prediction of atrial fibrillation following coronary bypass surgery

Ceylan¹,

Bayata²,

Yeşìl³

et al. 2010

Anadolu Kardiyol Derg

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Koroner baypas cerrahisi sonrası atriyal fibrilasyonu öngörmede interatriyal ileti süresi ve P dalga dispersiyonunun değeriValue of interatrial conduction time and P wave dispersion in the prediction of atrial fibrillation following coronary bypass surgery Özgün Araşt›rma Original Investigation 495Yaz›şma Adresi/Address GirişAtriyal fibrilasyon (AF) kardiyak cerrahi sonrası görülen aritmik komplikasyonların başında gelir. Operasyon öncesi alınan tüm önlemlere ve gelişen cerrahi tekniklere rağmen halen %20 ile %40 gibi yüksek oranlarda görülmektedir (1). Postoperatif AF gelişimi ile ilgili birçok risk faktörü ve prediktör belirlenmiştir. Önceden var olan AF öyküsü, ileri yaş, yapısal kalp hastalıkları gibi cerrahi ile ilişkisiz AF oluşumunda da etkili faktörlerin yanın-da, beta-blokerlerin kesilmesi, uzamış operasyon ve kardiyopulmoner baypas (KPB), sağ koroner arter tutulumu, intraaortik balon pompası (İABP) kullanımı gibi cerrahi ile ilişkili faktörler bunlardan bazılarıdır (2, 3).Atriyal ileti ve refrakterlik özelliklerindeki değişimlerin AF oluşumu ile ilişkili olduğu gösterilmiştir (4, 5). Atriyumlarda heterojen elektriksel iletim ve heterojen refrakterliğin göstergesi olan ve en uzun ile en kısa P dalga süreleri arasındaki fark olarak tanımlanan P dalga dispersiyonunun (PDD) değişik hasta popü-lasyonlarında gerek AF oluşumunu gerekse de kardiyoversiyon sonrasında AF rekürrensini öngörmede kullanılabileceğine dair yayınlar vardır (4, 6, 7). Öte yandan PDD'nin hesaplanmasında kullanılan en uzun P dalga süresinin bozulmuş interatriyal ileti ile ilişkili olduğu bilinmektedir (6). Paroksismal AF'li hastalarda bozulmuş interatriyal ileti ve uzamış interatriyal ileti süresi gös-terilmiş olmakla birlikte bu parametrenin değişik hasta popülas-yonlarında AF gelişimini öngörücü gücü konusunda yeterli bilgi yoktur (5, 8). Bu nedenle bu çalışmada, daha önce paroksismal AF gelişimini öngördüğü çeşitli çalışmalarla gösterilen ikincil değişken PDD'ye ilave olarak PDD'nin oluşumuna katkıda bulunan ve üzerinde yeterince çalışılmamış olan birincil değişken İAİS ile koroner arter baypas cerrahisi (KABC) sonrası AF gelişi-mi arasındaki ilişki araştırılmıştır. Yöntemler Hasta popülasyonuHastanemize elektif KABC için yatan ve sinüs ritminde olan 81 hasta bu prospektif, gözlemsel çalışmaya alındı. Atriyal fibrilasyon öyküsü, ileti sistemi hastalığı, ritim üzerine etkili endokrin hastalığı, kronik böbrek yetmezliği, orta-ciddi kapak hastalığı ve ciddi hipertrofi gibi ek yapısal kalp hastalığı olan, ejeksiyon fraksiyonu %55' in altında, elektrolit dengesizliği olan, beta-bloker dışı antiaritmik ilaç kullanan, KABC dışı ek bir cerrahi uygulanacak olan ve acil operasyona alınan hastalar çalışmaya alınmadı. Olguların preoperatif dönemde kullanmakta oldukları statin, beta-bloker ve anjiyotensin dönüştürücü enzim inhibitörü / anjiyotensin reseptör blokeri (ACEİ/ARB) gibi ilaçlar postoperatif dönemde de hastanın durumuna uygun şekilde devam edildi. Sinüs ritminde cerrahiye alınan bir olguda hastanede yatış döneminde saptanan, süreden bağ...

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“…12 In another study it was seen that PD was significantly prolonged in cases with paroxysmal AF, in contrast to cases without paroxysmal AF, even though left atrium sizes of both groups were equal. 13 It was shown that DM is an independent and strong risk factor for development of AF. 14,15 The frequency of AF development is 1.4-2.1-fold higher in cases with DM than cases without DM.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Diabetes Mellitus on the P-Wave Dispersion

Yazıcı

Özdemi̇r

Altunkeser

et al. 2007

Circ J

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-wave dispersion (PD) is defined as the difference between the minimum (P min) and maximum (P max) P-wave durations on standard 12-lead electrocardiography (ECG). PD is a measure of heterogeneity of atrial refractoriness and prolongation of PD shows the intra-atrial and inter-atrial non-uniform conduction. 1 In previous studies it was shown that PD prolongation is an independent risk factor for development of atrial fibrillation (AF). 2,3 AF is the most frequently encountered rhythm disturbance in clinical practice and its frequency increases 2-fold in every decade after 55 years old. 4 Although AF is often associated with structural heart diseases, there is no detectable heart disease in a substantial portion of the cases. 5 It was shown in epidemiological studies that the rate of development of AF in diabetic cases is higher than normal cases. 6 The pathological mechanisms related to initiation and maintainance of AF in patients with diabetes mellitus (DM) has not been well described. In diabetic cases it is thought that myocardial ischemia as a result of coronary microcirculation disorders or metabolic stress on atrium can play a role. Hypertension and coronary artery diseases, which are important factors in development of AF, often accompany DM. No study evaluating PD in diabetic cases without hypertension and coronary artery disease has yet been published.In the current study we planned to investigate PD in noncomplicated diabetic patients. MethodsSeventy-six diabetic patients who had no coronary artery disease or hypertension (group1; mean age 48±9 years) and 40 healthy volunteer individuals (group2; mean age 46±13 years) were enrolled in the study. Patients with DM history, taking anti-diabetic medicine and patients whose fasting glucose level is 126mg/dl or above were accepted as diabetic. 7 Of the diabetic cases, 25 (33%) were receiving insulin (mean 26±6U/day) and 51 (67%) of the cases were receiving oral anti-diabetic treatment. The cases whose fundus examination showed retinopathy were not included in the study. Cases with history of myocardial infarction, angina pectoris or other clinical findings of coronary artery diseases were not included in the study. Resting 12-lead ECG and maximal treadmill exercise test (according to Bruce protocol) were performed in every case. Cases who had right bundle-branch block, left bundle-branch block, Wolff-Parkinson-White syndrome, intraventricular conduction defect in resting ECG and anginal chest pain or ischemic ECG changes during the exercise test were excluded from the study. Patients with a history of AF, having a permanent pacemaker, taking anti-arrhythmic medicine, having a thyroid disease, left ventricular hypertrophy, and/or left ventricular dysfunction were also excluded. The 24-h Holter ECG records of the cases were obtained. Holter WIN-PV plus program was used for these records.We paid attention to the patient's renal and hepatic functions and monitored the levels so they were kept in normal Background P-wave dispersion (PD), a measure of heterogeneit...

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Effect of left atrial size and function on P‐wave dispersion: A study in patients with paroxysmal atrial fibrillation

Cited by 49 publications

References 15 publications

Effect of Ongoing Inflammation in Rheumatoid Arthritis on P-Wave Dispersion

Effect of Ongoing Inflammation in Rheumatoid Arthritis on P-Wave Dispersion

Value of interatrial conduction time and P wave dispersion in prediction of atrial fibrillation following coronary bypass surgery

The Effect of Diabetes Mellitus on the P-Wave Dispersion

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