P wave duration in paroxysmal and persistent atrial fibrillation

Abstract

Functional and structural changes in atrial muscle constitute a substrate for atrial fibrillation. The pathological changes in the left atrium decrease conduction velocity and result in prolongation of the P wave duration. The aim of the study was to assess the duration of the P wave in patients with paroxysmal and persistent atrial fibrillation. The study group consisted of 119 patients diagnosed with atrial fibrillation, 57 women and 62 men, aged 65.3+/-9.4 years. There were 65 patients with paroxysmal AF and 54 with persistent AF. In this group the electrical cardioversion was performed. The P wave duration, was measured using electrophysiological system in all leads at paper speed of 200 mm/s. The studied patients did not differ in term of age, gender and comorbidities. The patients with persistent AF had longer P wave duration (159.9+/-22.3 vs 144.6+/-17.2 ms, p<0.001), higher glucose concentration (119.4+/-33.4 vs 108.0+/-24.6 mg/dL, p=0.015). Those results were not influenced by the anti-arrhythmic treatment. The persistent atrial fibrillation shows prolongation of the P wave duration over the paroxysmal form of the arrhythmia, independently to age, gender and anti-arrhythmic medication. The prolongation of the P wave related to persistent arrhythmia should force the physicians to earlier restoration of the sinus rhythm in order to its more successful long term maintenance.

Atrial late potentials are associated with atrial fibrillation recurrence after catheter ablation

“…P-wave duration on surface 12-lead ECG has also been associated with AF recurrence after CA. 17,18 A long P-wave duration is associated with an enlarged LA 19 and atrial conduction disturbance. 20 We demonstrated that positive ALP was an independent predictor of AF recurrence after CA, and there were no significant differences in the LAD and P-wave duration on surface 12-lead ECG between the Recurrence and Non-Recurrence groups.…”

Atrial late potentials are associated with atrial fibrillation recurrence after catheter ablation

“…PWD on the surface 12-lead ECG has also been described to be associated with AF recurrence after CA. 18,19 A long PWD is reported to be associated with an enlarged LA 20 and atrial conduction disturbances. 21 We demonstrated that positive ALP was an independent predictor of AF recurrence after CA, and there were no significant differences found for the LAD and PWD on the surface 12-lead ECG between the recurrence and nonrecurrence groups.…”