Prolonged P-wave duration is associated with atrial fibrillation recurrence after successful pulmonary vein isolation for paroxysmal atrial fibrillation

Caldwell, Jane C.; Koppikar, Sahil; Barake, Walid; Redfearn, Damián P.; Michael, Kevin; Simpson, Christopher S.; Hopman, Wilma M.; Baranchuk, Adrián

doi:10.1007/s10840-013-9851-1

Cited by 100 publications

(77 citation statements)

References 22 publications

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“…17,18 The delayed and heterogeneous activation of the LA results in dispersion of atrial refractory periods, interatrial dyssynchrony and impaired LA mechanical function, 19,20 all of which favor the development of AF. Thus, IAB (partial or advanced) has been found to be associated with new-onset AF in patients from a general hospital population, 21 , recurrence of AF postelectrical or pharmacological cardioversion, 22,23 , AF recurrence after pulmonary vein isolation, 24 and progression of paroxysmal AF to the persistent or permanent forms of the disease. 25,26 In patients with CHF, the association of Pwave abnormalities with development of AF was first described by Yamada et al 15 using signal averaged ECG (SAECG).…”

Section: Discussionmentioning

confidence: 99%

Advanced Interatrial Block Predicts New Onset Atrial Fibrillation in Patients with Severe Heart Failure and Cardiac Resynchronization Therapy

Ali

Enríquez

Conde

et al. 2015

Ann Noninvasive Electrocardiol

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Section: Discussionmentioning

confidence: 99%

Advanced Interatrial Block Predicts New Onset Atrial Fibrillation in Patients with Severe Heart Failure and Cardiac Resynchronization Therapy

Ali

Enríquez

Conde

et al. 2015

Ann Noninvasive Electrocardiol

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“…5,6 It has been independently associated with incident AF 8,10–12 and recurrent AF after pulmonary vein isolation. 9 Prospective cohort studies have demonstrated that incident AF carries an independent risk of death from cardiovascular disease and all causes. 2,19 AF can reduce the threshold for ventricular arrhythmias by directly reducing refractoriness 20 and generating pro-arrhythmic short-long-short sequences.…”

Section: Discussionmentioning

confidence: 99%

Relation of Prolonged P-Wave Duration to Risk of Sudden Cardiac Death in the General Population (from the Atherosclerosis Risk in Communities Study)

Maheshwari

Norby

Soliman

et al. 2017

The American Journal of Cardiology

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Prolonged P-wave duration, a marker of left atrial abnormality, is associated with myocardial fibrosis, atrial fibrillation (AF), and all-cause death. It is not known if prolonged P-wave duration is associated with sudden cardiac death (SCD) in the general population. We aimed to evaluate whether prolonged P-wave duration is independently associated with SCD risk in the Atherosclerosis Risk in Communities Study, a community-based prospective cohort study. We included 15,321 participants in our analysis (age: 54.2±5.7, 55.2% women, 26.4% black). Prolonged P-wave duration was defined as maximum P-wave duration >120 ms and was determined from 12-lead electrocardiograms (ECGs) obtained during 4 exams (1987–1999). SCD was physician adjudicated and defined as a sudden, pulseless condition in a previously stable individual without evidence for non-cardiac cause of death. We used Cox proportional hazard models to assess the association between prolonged P-wave duration and SCD, adjusting for cardiovascular risk factors and conditions including atrial fibrillation. During a mean follow-up of 12.5 years (1987–2001), 268 SCDs were identified. The multivariable hazard ratio (95% CI) of prolonged P-wave duration for SCD was 1.70 (1.31–2.20). This association was attenuated, but remained significant after updating covariates to the end of follow-up with a hazard ratio of 1.35 (1.04–1.76). In conclusion, prolonged P-wave duration is independently associated with increased risk of SCD in the general population. This association is independent of AF and is only partially mediated by shared cardiovascular risk factors.

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“…Pwd is an electrocardiographic marker associated with inhomogeneous and discontinuous propagation of sinus impulses (5). Prolonged P-wave duration and increased Pwd have been reported to carry an increased risk of atrial fibrillation (AF) (6). QT dispersion (QTd) can be used to assess the homogeneity of cardiac repolarization (7).…”

Section: Introductionmentioning

confidence: 99%

Effects of balanced propofol sedation on QT, corrected QT, and P-wave dispersion on upper endoscopy

Bolat

Celıkbılek²,

Sarıkaya³

et al. 2015

Anatol J Cardiol

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Objective:Combined sedation with propofol and benzodiazepines, known as balanced propofol sedation (BPS), was developed to increase patient comfort during endoscopy. However, the effects of BPS on P-wave dispersion (Pwd), QT interval, and corrected QT (QTc) interval after endoscopy have not been investigated.Methods:The study population consisted of 40 patients with BPS and 42 without sedation who were scheduled to undergo upper endoscopy in this cross-sectional prospective study. Patients with hypertension, diabetes mellitus, renal failure, chronic obstructive pulmonary disease, coronary artery disease, or valvular heart disease and those on medications that interfere with cardiac conduction times were excluded. Electrocardiograms (ECGs) was recorded in all patients pre-endoscopy and 10 min post-endoscopy. QT, QT dispersion (QTd), and Pwd were defined from 12-lead ECG. The QTc interval was calculated using Bazett’s formula. All analyses were performed using SPSS 15.0.Results:Post-endoscopy P max duration and Pwd were prolonged compared with baseline values (86±13 ms vs. 92±10 ms and 29±12 ms vs. 33±12 ms, respectively; p<0.05). Post-endoscopy QTc and QTd were decreased compared with baseline values, but these decreases were not statistically significant (431±25 ms vs. 416±30 ms and 62±28 ms vs. 43±22 ms, respectively; p>0.05).Conclusion:The present study showed that P-wave duration and Pwd values increased after endoscopy with a combination of midazolam and propofol sedation. Physicians should be made aware of the potential effects of BPS in terms on P-wave duration and Pwd values.

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Prolonged P-wave duration is associated with atrial fibrillation recurrence after successful pulmonary vein isolation for paroxysmal atrial fibrillation

Abstract: The presence of pre-existent prolonged PWD is associated with a higher risk of AF recurrence post PVI for paroxysmal AF.

Cited by 100 publications

References 22 publications

Advanced Interatrial Block Predicts New Onset Atrial Fibrillation in Patients with Severe Heart Failure and Cardiac Resynchronization Therapy

Advanced Interatrial Block Predicts New Onset Atrial Fibrillation in Patients with Severe Heart Failure and Cardiac Resynchronization Therapy

Relation of Prolonged P-Wave Duration to Risk of Sudden Cardiac Death in the General Population (from the Atherosclerosis Risk in Communities Study)

Effects of balanced propofol sedation on QT, corrected QT, and P-wave dispersion on upper endoscopy

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