New Parameter of the Second Half of the P-Wave, P-Wave Duration, and Atrial Conduction Times Predict Atrial Fibrillation during Electrophysiological Studies

Puerta, Raimundo Carmona; Martínez, Elizabeth Lorenzo; López-Calleja, Magda Alina Rabassa; Peña, Gustavo Padrón; Torres, Yaniel Castro; Elizundia, Juan Miguel Cruz; González, Fernando Rodríguez; Vázquez, Luis Ángel García; González, Elibet Chávez

doi:10.1159/000518262

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…Atrial size is an important factor for the perpetuation of AF since it facilitates the development of re-entry circuits by increasing the conduction time [ 35 , 50 , 57 ]. However, whilst a prolongation in P wave duration is commonly associated with AF [ 4 , 5 , 12 , 46 , 58 ], only a few studies have related the increase in P wave duration to atrial enlargement per se [ 59 , 60 ]. In athletes, lifetime training hours were associated with the prolongation in P wave duration and an increase in left atrial volume in one study [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of P Wave Indices in Healthy Standardbred Horses

White

Nath

Hebart

et al. 2023

Animals

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P wave indices are used as non-invasive electrocardiographic markers of atrial remodelling in humans. Few studies have investigated their use in animals. The aim of this study was to measure P wave duration and P wave dispersion (Pd) in healthy standardbred horses and investigate variables that might influence these measurements. A 12-lead electrocardiogram was recorded at rest and P wave indices were calculated in 53 horses. A general linear model was used to investigate the main effects: age, bodyweight, sex, resting heart rate, presence of a murmur, exercise status and the number of years raced. There were significant associations with exercise status for both the maximum P wave duration and Pd, with both values being increased in strenuously exercising versus non-active horses. Furthermore, a significant moderate positive correlation was identified between the duration of exercise (number of years raced) and both Pmax and Pd. No other significant associations were identified. These findings are similar to those reported in elite human athletes versus sedentary individuals. The increases in these P wave indices most likely occur due to prolongation and heterogeneity in atrial conduction time, which are associated with structural and electrical remodelling, and may explain the increased risk of atrial fibrillation in athletic horses.

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Section: Discussionmentioning

confidence: 99%

Assessment of P Wave Indices in Healthy Standardbred Horses

White

Nath

Hebart

et al. 2023

Animals

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“…Analysis of P-wave morphology can reveal important information about atrial depolarization. Increase in P-wave duration may occur in pathological conditions such as nonhomogeneous and discontinuous atrial conduction leading to atrial enlargement and may be harbinger for atrial arrhythmias such as atrial fibrillation ( Carmona Puerta et al, 2021 ). In our study, we found that P-wave duration is not significantly different between AF players and other nondisabled groups.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of electrocardiographic parameters in amputee football players

Kurtoğlu,

Akgümüş

et al. 2023

Front. Psychol.

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ObjectiveThe present study aimed to compare electrocardiographic (ECG) parameters of amputee football players (AF) with football players without disability (FP) and sedentary individuals without disability (SI).MethodsA total of 32 participants (AF = 9, FP = 11, SI = 12) were included in the study. ECG parameters including P-wave amplitude, P-wave duration, PR interval, QRS duration, RR interval, QT interval, corrected-QT interval (QTc), ST segment duration, Tp-e duration, Tp-e/QT and Tp-e/QTc ratios were assessed in all the study participants by using a 12-lead ECG device. OneWay ANOVA Test was used for statistical analysis.ResultsOf all ECG parameters, P-wave amplitude and QTc were significantly higher in the AF group in comparison to FP and SI groups. QRS duration was found to be lower in the AF group when compared to FP and SI groups. Myocardial repolarization parameters including Tp-e duration, Tp-e/QT and Tp-e/QTc ratios were similar between groups, as were other parameters such as P-wave duration, PR interval, RR interval, QRS duration and QT interval.ConclusionIt was found that some ECG parameters of amputee football players differ from those with non-disabled players and non-disabled sedentary individuals. These different parameters were within normal limits.

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“…The significance of the second P-wave part in clinical environment was recently appreciated in a study that investigated the correlation of P-wave parameters with inter- and intra-atrial conduction times measured via invasive analysis, finding a relatively high correlation between the second P-wave part and LA conduction times [ 52 ]. The study additionally used surface and invasive parameters to discern between AF occurrence and non-AF occurrence during electrophysiological studies of a randomly chosen set of patients.…”

Section: Discussionmentioning

confidence: 99%

Splitting the P-Wave: Improved Evaluation of Left Atrial Substrate Modification after Pulmonary Vein Isolation of Paroxysmal Atrial Fibrillation

Vraka

Bertomeu-González

Hornero

et al. 2021

Sensors

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Atrial substrate modification after pulmonary vein isolation (PVI) of paroxysmal atrial fibrillation (pAF) can be assessed non-invasively by analyzing P-wave duration in the electrocardiogram (ECG). However, whether right (RA) and left atrium (LA) contribute equally to this phenomenon remains unknown. The present study splits fundamental P-wave features to investigate the different RA and LA contributions to P-wave duration. Recordings of 29 pAF patients undergoing first-ever PVI were acquired before and after PVI. P-wave features were calculated: P-wave duration (PWD), duration of the first (PWDon-peak) and second (PWDpeak-off) P-wave halves, estimating RA and LA conduction, respectively. P-wave onset (PWon-R) or offset (PWoff-R) to R-peak interval, measuring combined atrial/atrioventricular and single atrioventricular conduction, respectively. Heart-rate fluctuation was corrected by scaling. Pre- and post-PVI results were compared with Mann–Whitney U-test. PWD was correlated with the remaining features. Only PWD (non-scaling: Δ=−9.84%, p=0.0085, scaling: Δ=−17.96%, p=0.0442) and PWDpeak-off (non-scaling: Δ=−22.03%, p=0.0250, scaling: Δ=−27.77%, p=0.0268) were decreased. Correlation of all features with PWD was significant before/after PVI (p<0.0001), showing the highest value between PWD and PWon-R (ρmax=0.855). PWD correlated more with PWDon-peak (ρ= 0.540–0.805) than PWDpeak-off (ρ= 0.419–0.710). PWD shortening after PVI of pAF stems mainly from the second half of the P-wave. Therefore, noninvasive estimation of LA conduction time is critical for the study of atrial substrate modification after PVI and should be addressed by splitting the P-wave in order to achieve improved estimations.

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New Parameter of the Second Half of the P-Wave, P-Wave Duration, and Atrial Conduction Times Predict Atrial Fibrillation during Electrophysiological Studies

Cited by 4 publications

References 27 publications

Assessment of P Wave Indices in Healthy Standardbred Horses

Assessment of P Wave Indices in Healthy Standardbred Horses

Evaluation of electrocardiographic parameters in amputee football players

Splitting the P-Wave: Improved Evaluation of Left Atrial Substrate Modification after Pulmonary Vein Isolation of Paroxysmal Atrial Fibrillation

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