Signal-averaged P wave duration and the long-term risk of permanent atrial fibrillation

Abstract

Prolonged SAPWD (a marker of atrial remodelling) appears to be a risk factor for long-term development of permanent AF.

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

“…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). They reported abnormal P-wave duration by SAECG in 38% of patients at baseline and higher incidence of paroxysmal AF in subjects with rather than without abnormal P-wave duration during the follow-up (32% vs 2%; P = 0.0002).…”

Celecoxib‐Induced Change in Atrial Electrophysiologic Substrate in Arthritis Patients

“…However, there was no difference in mean PWD between the healthy controls and the inflammatory arthritis cohort. The signal‐averaged PWD is a well‐validated method that can be used to predict AF development . In patients diagnosed with paroxysmal AF, PWD is significantly longer as compared to healthy control patients, and is a marker of the adverse electromechanical remodeling within the atria of AF patients, with marked changes in PWD yielding high risk of AF development .…”

Usefulness of a Combination of Interatrial Block and a High CHADS₂ Score to Predict New Onset Atrial Fibrillation

“…[7][8][9][10][11] A study by Bayes, et al found that, during a 30-month follow-up of 16 patients with IAB, half developed AF. 7) In an investigation by Agarwal, et al, 308 patients developed AF during a mean of 16 months, and 52% had IAB.…”

“…This finding supports the findings of previous studies that IAB was associated with an increased risk of AF. [7][8][9][10][11] Patients meeting these criteria should also be followed for new onset AF.…”

“…Interatrial block (IAB) is manifested in the 12-lead electrocardiogram (ECG) by a P-wave duration > 120 ms, 6) and has been associated with increased risk of AF. [7][8][9][10][11] Currently, the CHADS 2 score is widely used for predicting future ischemic stroke in patients with AF. 12) Although AF is more prevalent in subjects with high CHADS 2 scores than in those with low CHADS 2 scores, 13,14) the combined role of IAB and the CHADS 2 score in new onset AF in patients in sinus rhythm remains unclear.…”