Prognostic Value of P Wave for Developing Atrial Fibrillation

Hayashi, Hideki; Horie, Minoru

doi:10.5772/27562

Cited by 1 publication

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References 87 publications

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“…Grouping the patients according to the ECG and Echo findings Table 4 shows that the number of true negative cases is the most frequent. Chon and Helen used the term pseudo P-pulmonale to explain P-pulmonale in normal RA and may be due to left atrial forces contributing to the increased P-wave height; this can explain the pseudo positive cases 5,10 . Jeffry and associates showed in their study that the sensitivity of P-pulmonale was only 6%, but 100% specific 5 , this is quite different from the results of the current study, though it had been shown that the result of P-pulmonale specificity is more than its sensitivity (79% versus 49%) in the detection of right atrial dilatation, as well it has higher negative predictive value 77% versus 52%).…”

Section: Table (4)mentioning

confidence: 99%

The Value of P-Pulmonale as an Electrocardiographic Criterion for Detection of Right Atrial Dilatation

Faeq¹,

Faeq

Mena³

2016

Adv.med.j.

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Background and objectives: There are many electrocardiographic (ECG) criteria for detection of right atrial dilatation (maximum diameter of more than 5.3 mm), the most common one is P- pulmonale which is manifested by a tall P- wave in the inferior leads mainly lead II (P- wave equal or more than 2.5 mm), although this criteria is subjected to criticism regarding its sensitivity, specificity and predictive values, but it is still regarded as a main criteria. This study was designed to estimate the sensitivity, specificity, predictive values and accuracy of P- pulmonale in the detection of right atrial dilatation. Methods: Two hundred patients with different pathologies that can lead to right atrial dilatation had been included in the study from 2013-7-1 to 2015-9-1. ECG and two dimensional chocardiography had been performed for all patients, P- wave in lead II of 2.5 mm or more had been regarded as P- pulmonale, right atrial maximum dimension in apical four chamber view transthoracic two dimensional echocardiography of more than 5.3 mm had been regarded as dilated right atrium. The patients accordingly were divided into four groups (true positive, true negative, false positive and false negative). Results: The study included patients of different ages, male to female ratio was 3:2, and the patients had different pathologies that could lead to dilated right atrium. Sensitivity of P-pulmonale was %49, specificity %79, positive predictive value of %51, negative predictive value of 77 % and accuracy] of %70.5. Conclusions: P-pulmonale is a reliable criterion for the detection of right atrial dilatation although it has variable sensitivity. It is more specific than being sensitive. The negative predictive value of P-pulmonale is higher than its positive predictive value.

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Section: Table (4)mentioning

confidence: 99%