Prediction of paroxysmal atrial fibrillation in patients with congestive heart failure: a prospective study

Yamada, Takahisa; Fukunami, Masatake; Shimonagata, Tsuyoshi; Kumagai, Kazuaki; Ogita, Hisakazu; Asano, Yoshihiro; Hirata, Akio; Hori, Masatsugu; Hoki, Noritake

doi:10.1016/s0735-1097(99)00563-x

Cited by 115 publications

(60 citation statements)

References 29 publications

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“…The onset of the P-wave was defined as the point of the first visible upward departure of the trace from the bottom of the baseline for the positive waves, and as the point of the first downward departure from the top of the baseline for negative waves. The return of the bottom of the trace to the baseline in positive waves was considered to be the end of the P-wave 18 . After the recording, the measurements were performed by two trained and independent observers before the echocardiogram was performed; these were blinded to patients' clinical condition, so as to analyze interobserver variability.…”

Section: Resultsmentioning

confidence: 99%

“…Considering the HF picture, the prognostic studies on P-wave measurements in conjunction with those of the left atrium are scarce 11,18 , which motivated the present study. The main objective of this study is to correlate the P-wave measurements with left atrial volume and its index and verify the prognostic value of these measurements and other variables in stable patients with HF.…”

Section: Introductionmentioning

confidence: 99%

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Dispersão da onda P e índice de volume do átrio esquerdo como preditores na insuficiência cardíaca

Silva¹,

N²,

Torres³

et al. 2013

Arq. Bras. Cardiol.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dispersão da onda P e índice de volume do átrio esquerdo como preditores na insuficiência cardíaca

Silva¹,

N²,

Torres³

et al. 2013

Arq. Bras. Cardiol.

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“…10 Alterations of P-wave duration have been studied in several clinical settings, such as idiopathic PAF, ischemic heart diseases, after coronary artery bypass surgery, hypertension, and congestive heart failure. [11][12][13][14][15][16] Recently, P-wave dispersion (Pd) has been proposed to be a useful index for identifying the risk for AF in several clinical conditions. 11,15 Thus, in the present study, we investigated whether Pd could be used to discriminate between patients with HCM with and without a history of PAF.…”

Section: Introductionmentioning

confidence: 99%

Detection of patients with hypertrophic cardiomyopathy at risk for paroxysmal atrial fibrillation during sinus rhythm by P‐wave dispersion

Köse

Aytemir

Sade

et al. 2003

Clinical Cardiology

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SummaryBackground: Paroxysmal atrial fibrillation (PAF) in hypertrophic cardiomyopathy (HCM) is associated with poor prognosis. Previous studies have shown good correlation between P-wave dispersion (Pd) and occurrence of PAF. However, Pd in patients with HCM for predicting PAF has not been studied.Hypothesis: The aim of the study was to determine whether Pd could identify patients with HCM who are likely to suffer from PAF.Methods: Twenty-two patients with HCM with a history of PAF (Group 1) and 26 patients with HCM without a history of PAF (Group 2) were studied. Maximum (Pmax) and minimum (Pmin) P-wave durations, as well as P-wave dispersion (Pd = Pmax ϪPmin) were calculated from 12-lead surface electrocardiograms (ECG).Results: P-wave dispersion was significantly different between the groups (Group 1: 55 ± 6 ms vs. Group 2: 37 ± 8 ms; p < 0.001), while Pmax (Group 1: 134 ± 11 ms vs. Group 2: 128 ± 13 ms; p = 0.06) and Pmin (Group 1: 78 ± 9 ms vs. Group 2: 81 ± 7 ms; p = 0.07) was not significantly different. Patients with a history of PAF had higher left atrial diameter than the patients without PAF (Group 1: 52 ± 8 mm vs. Group 2: 48 ± 10 mm; p = 0.02). A cut-off value of 46 ms for Pd had a sensitivity of 76% and a specificity of 82% in discriminating between patients with and without PAF.Conclusion: This study suggests that P-wave dispersion could identify patients with HCM who are likely to develop PAF.

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“…Supporting this concept, the stretching of the atrial wall may increase the level of atrial natriuretic factor, which is also predictive for AF. 22 Even asymptomatic subjects from the general population with mild left ventricular systolic dysfunction have increased BNP levels. 20 In addition, the beneficial effects of ACE inhibition on incident AF possibly through favourable modification of the remodelling processes in patients with heart failure support this relation between structural abnormalities and AF.…”

mentioning

confidence: 99%

N-terminal pro B-type natriuretic peptide levels predict newly detected atrial fibrillation in a population-based cohort

Asselbergs¹,

Berg²,

Bakker³

et al. 2008

NHJL

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Background. B-type natriuretic peptide (BNP) is secreted from cardiomyocytes and may reflect haemodynamic abnormalities predisposing to atrial fibrillation (AF). We aimed to investigate whether N-terminal pro BNP (NT-proBNP) is associated with newly detected AF in subjects obtained from the general population. Methods. From the PREVEND programme (n=8592), we selected all subjects with an available baseline and four-year electrocardiogram and NTproBNP levels at baseline. We excluded subjects with AF at baseline and subjects with a serum creatinine >2.0 mg/dl. Results. In total, 6494 subjects were eligible for the prospective analysis (aged 49±12 years, 49.7% men). At four years, AF was detected in 41 (0.6%) subjects. Median NT-proBNP levels at baseline in subjects with newly detected AF after four years was 62.2 (22.6 to 208.5) pg/ml as compared with 35.7 (15.9 to 68.7) pg/ml in those with sinus rhythm (p=0.001). Each 1 standard deviation increment in natural log transformed NT-proBNP was associated with a 54% (5% to 126%, p=0.028) increase in risk for AF after adjustment for other risk factors predisposing to AF. NT-proBNP levels above the sex-specific 80th percentile (97 pg/ml in women and 60 pg/ml in men) were associated with a multivariate odds ratio of 2.65 (1.22 to 5.76, p=0.01) for the occurrence of AF. Conclusion. Plasma levels of NT-proBNP predict newly detected AF in subjects obtained from the general population independent of cardiovascular risk factors predisposing to AF. (Neth Heart J 2008;16:73-8.)

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Prediction of paroxysmal atrial fibrillation in patients with congestive heart failure: a prospective study

Abstract: An abnormal P-SAECG and elevated ANP level could be predictors of PAF development in patients with CHF.

Cited by 115 publications

References 29 publications

Dispersão da onda P e índice de volume do átrio esquerdo como preditores na insuficiência cardíaca

Dispersão da onda P e índice de volume do átrio esquerdo como preditores na insuficiência cardíaca

Detection of patients with hypertrophic cardiomyopathy at risk for paroxysmal atrial fibrillation during sinus rhythm by P‐wave dispersion

N-terminal pro B-type natriuretic peptide levels predict newly detected atrial fibrillation in a population-based cohort

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