Immediate effect of percutaneous transvenous mitral commissurotomy on atrial electromechanical delay and P-wave dispersion in patients with severe mitral stenosis

Beig, Jahangir Rashid; Tramboo, Nisar A.; Rather, Hilal; Hafeez, Imran; Ananth, Vijai; Lone, Ajaz Ahmad; Yaqoob, Irfan; Bhat, Irfan Ahmad; Ali, Manzoor

doi:10.1016/j.ihj.2015.10.375

Cited by 7 publications

(5 citation statements)

References 40 publications

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“…Successful PTMC has a favorable early impact on inter and intraatrial electromechanical delays, which are considered as novel parameters of atrial electromechanical remodeling in MS patients [11].…”

Section: Normal Limit Values Of P-wave Dispersion (Pwd)mentioning

confidence: 99%

P-wave dispersion: an update

Pérez‐Riera

Abreu

Barbosa‐Barros

et al. 2016

Indian Pacing and Electrophysiology Journal

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P-wave dispersion (PWD, Pd or Pdis) is a noninvasive electrocardiographic (ECG) marker for atrial remodeling and predictor for atrial fibrillation (AF). PWD is defined as the difference between the widest and the narrowest P-wave duration recorded from the 12 ECG leads. Increased P-wave duration and PWD reflect prolongation of intraatrial and interatrial conduction time with lack of a well-coordinated conduction system within the atrial muscles, with inhomogeneous, asynchronic, pro-inflammatory and anti-inflammatory effect mediated by interleukin-6 (IL-6) in patients with the CG + GG genotype IL-6 -634C/G polymorphism [1] and discontinuous propagation of sinus impulses mainly between the left and right atria, interstitial/extracellular fibroblast activation and collagen deposition with fibrosis (via TGF-β) in atrial tissue, insufficient blood supply, significant not isotropic myoelectric activity, and thin wall thickness and consequent expansion tendency all well-known electrophysiological characteristics in patients with atrial arrhythmias and especially paroxysmal atrial fibrillation (PAF) [2].

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Section: Normal Limit Values Of P-wave Dispersion (Pwd)mentioning

confidence: 99%

P-wave dispersion: an update

Pérez‐Riera

Abreu

Barbosa‐Barros

et al. 2016

Indian Pacing and Electrophysiology Journal

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“…Similar to our results; successful PMBV procedure results in a decrease in PWD. The decline of PWD immediately after PMBV was not supported by Beig et al [15] ; they found statistically significant decrease in inter and intraatrial electromechanical delays. Prolongation of P-wave duration and increased PWD were correlated with increased AF risk according to previous studies [5,16] .…”

Section: Resultsmentioning

confidence: 81%

Immediate And Long Term Effects Of Percutaneous Mitral Balloon Valvuloplasty On Atrial Conduction Velocities In Patients With Mitral Stenosis

Ağuş¹,

Kahraman²,

Uygur³

et al. 2019

Journal of Atrial Fibrillation

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Background: P-wave dispersion (PWD) is an electrocardiographic (ECG) marker of nonuniform and heterogeneous atrial conduction with ECG leads of different orientation. The aim of our study was to investigate the immediate and long term effects of successful percutaneous mitral balloon valvuloplasty (PMBV) on PWD in severe rheumatic MS patients and to analyse the restenosis, atrial fibrillation (AF) and redo balloon valvuloplasty rate. Methods:We enrolled 41 consecutive MS patients with sinus rhythm who underwent PMBV. A 12-lead ECG and transthoracic echocardiography were performed for each patient one day before, within 72 hours after the procedure and followed up by clinical visit at a mean of 5,57±1,46 (3-8) year.The mean patient age was 44.1±10.86 years. Results: Pmax 1(pre PMBV) and PWD 1(pre PMBV) decreased 1-3 days after PMBV. MVA improved immediately after the procedure; but lately the mean MVA decreased significantly indicating the initiation of restenosis. Composite endpoints were associated with LA 1 (p = 0.02), MVA 2 (1-3 days after PMBV) (p= 0.019), mean gradient 2 (p= 0.028), PWD 3 (3 years after PMBV) (p < 0.001) and Pmax 3 (3 years after PMBV) (<0,001). AF incidence was associated with PWD 2 (p=0,019) and PWD 3 (p=0,010). There was 14 composite endpoint on follow up and at multivariate analysis PWD 3 was identified as an independent predictor of the composite endpoint (p=0.048, hazard ratio=1.36, 95% confidence interval (CI): 1,002−1.867). Conclusions: This study has demonstrated that Pmax and PWD significantly decreased within 3 days after PMBV. Furthermore, long term PWD was associated with AF and identified as an independent predictor of the composite endpoint.

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“…Se ha realizado una amplia investigación clínica de la dispersión de la onda P en el análisis del riesgo de fibrilación auricular en pacientes sin cardiopatía orgánica, en pacientes con enfermedad coronaria, en pacientes sometidos a cirugía de derivación coronaria, en pacientes con cardiopatías congénitas, así como en otros grupos de pacientes que padecen diversas enfermedades cardiacas o no (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) cardiacas . En consecuencia, la PWD puede ser útil para discriminar a pacientes con diferentes tipos de enfermedades que son propensas a desarrollar FA (31)(32)(33)(34)(35)(36) paroxística en el curso de sus vidas .…”

Section: Discussionunclassified

Correlation among P wave dispersion and cardiac arrhythmias and alterations of the conduction system in patients with arterial hypertension from the Hospital de Clinicas, Asunción, Paraguay

Scavenius¹,

Centurión²,

Torales³

et al. 2019

Rev. salud publica Parag.

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Introducción: La hipertensión arterial puede producir cambios auriculares que generan arritmias auriculares. La dispersión de la onda P (PWD) se considera un marcador electrocardiográfico no invasivo para la remodelación auricular y un predictor para el desarrollo de fibrilación auricular. Objetivo: Estudiar la correlación entre la dispersión de la onda P con las arritmias cardíacas y los trastornos del sistema de conducción en pacientes con hipertensión arterial (HTA). Metodología: Estudio observacional y prospectivo en el que estudiamos las variaciones electrocardiográficas, mediciones ecocardiográficas y Holter ECG de 24 hs en pacientes hipertensos que acuden a un hospital terciario desde marzo del 2018 a septiembre del 2018 en forma ambulatoria y a internados. Resultados: Se estudiaron 104 pacientes, 65 hipertensos conocidos y 39 no hipertensos como grupo control. El valor promedio de la dispersión de la onda P en hipertensos fue de 37±8 ms, y en el grupo control fue de 27±13 ms, P <0,001. Además se encontró una diferencia significativa entre estos dos grupos en la duración máxima de la onda P (p<0,05), y el diámetro de la aurícula izquierda (p<0,05). La PWD posee una especificidad de 72% y un valor predictivo negativo de 78% relacionado con la presencia de trastornos del sistema de conducción y arritmias cardiacas en pacientes con HTA. Además, la PWD posee una especificidad de 73% y un valor predictivo negativo de 83% relacionado con la presencia de ensanchamiento del complejo QRS. Conclusiones: Existe una mayor alteración significativa en la

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Immediate effect of percutaneous transvenous mitral commissurotomy on atrial electromechanical delay and P-wave dispersion in patients with severe mitral stenosis

Cited by 7 publications

References 40 publications

P-wave dispersion: an update

P-wave dispersion: an update

Immediate And Long Term Effects Of Percutaneous Mitral Balloon Valvuloplasty On Atrial Conduction Velocities In Patients With Mitral Stenosis

Correlation among P wave dispersion and cardiac arrhythmias and alterations of the conduction system in patients with arterial hypertension from the Hospital de Clinicas, Asunción, Paraguay

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