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P Dispersion (p + dispersion)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Prevalence of Interatrial Block in Healthy School-Aged Children: Definition by P-Wave Duration or Morphological Analysis

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 1 2010
F.E.S.C., Polychronis Dilaveris M.D.
Background: P waves ,110 ms in adults and ,90 ms in children are considered abnormal, signifying interatrial block, particularly in the first case. Methods: To evaluate the prevalence of interatrial block in healthy school-aged children, we obtained 12-lead digital ECGs (Cardioperfect 1.1, CardioControl NV, Delft, The Netherlands) of 664 healthy children (349 males/315 females, age range 6,14 years old). P-wave analysis indices [mean, maximum and minimum (in the 12 leads) P-wave duration, P-wave dispersion, P-wave morphology in the derived orthogonal (X, Y, Z) leads, as well the amplitude of the maximum spatial P-wave vector] were calculated in all study participants. Results: P-wave descriptor values were: mean P-wave duration 84.9 ± 9.5 ms, maximum P-wave duration 99.0 ± 9.8 ms, P dispersion 32.2 ± 12.5 ms, spatial P amplitude 182.7 ± 69.0 ,V. P-wave morphology distribution in the orthogonal leads were: Type I 478 (72.0%), Type II 178 (26.8%), Type III 1 (0.2%), indeterminate 7 (1%). Maximum P-wave duration was positively correlated to age (P < 0.001) and did not differ between sexes (P = 0.339). Using the 90-ms value as cutoff for P-wave duration, 502 (75.6%) children would be classified as having maximum P-wave duration above reference range. The 95th and the 99th percentiles were in the overall population 117 ms and 125 ms, respectively. P-wave morphology type was not in any way correlated to P-wave duration (P = 0.715). Conclusions: Abnormal P-wave morphology signifying the presence of interatrial block is very rare in a healthy pediatric population, while widened P waves are quite common, although currently classified as abnormal. Ann Noninvasive Electrocardiol 2010;15(1):17,25 [source]

P-Wave Duration and Dispersion in Obese Subjects

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 1 2008
Feridun Kosar M.D.
Background: Although previous studies have documented a variety of electrocardiogram (ECG) abnormalities in obesity, P-wave alterations, which represent an increased risk for atrial arrhythmia, have not been studied very well in these patients. The aim of the present study was to evaluate P-wave duration and P dispersion (Pd) in obese subjects, and to investigate the relationship between P-wave measurements, and the clinical and echocardiographic variables. Methods: The study population consisted of 52 obese and 30 normal weight control subjects. P-wave duration and P-wave dispersion were calculated on the 12-lead ECG. As echocardiographic variables, left atrial diameter (LAD), left ventricular end-diastolic, and end-systolic diameters (LVDD and LVSD), left ventricular ejection fraction (LVEF), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), and left ventricular mass (LVM) of the obese and the control subjects were measured by means of transthoracic echocardiography. Results: There were statistically significant differences between obese and controls as regards to Pmax (maximum P-wave duration) and Pd (P dispersion) (P < 0.001 and P < 0.001, respectively). Pmin (minimum P wave duration) was similar in both groups. Correlation analysis showed that Pd in the obese patients was related to any the clinical and echocardiographic parameters including BMI, LAD, LVDD, IVST, LVPWT, and LVM. Conclusion: Our data suggest that obesity affects P-wave dispersion and duration, and changes in P dispersion may be closely related to the clinical and the echocardiographic parameters such as BMI, LAD, IVST, LVPWT, and LVM. [source]

P Wave Dispersion Predicts Recurrence of Paroxysmal Atrial Fibrillation in Patients with Atrioventricular Nodal Reentrant Tachycardia Treated with Radiofrequency Catheter Ablation

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2006
Basri Amasyali M.D.
Background: Paroxysmal atrial fibrillation (AF) recurs in up to one-third of patients with atrioventricular nodal reentrant tachycardia (AVNRT) treated with slow pathway ablation. Therefore, identification of patients at risk for recurrence of AF after slow pathway ablation is important because of the necessity for additional therapies. The purpose of this study was to determine whether successful slow pathway ablation influences P wave parameters and whether these parameters predict the recurrence of paroxysmal AF in patients with both AVNRT and paroxysmal AF after ablation. Methods: Thirty-six patients with AVNRT and documented paroxysmal AF (Group 1) were compared to 36 age-matched controls with AVNRT only (Group 2). P wave durations and P dispersion were measured before and after ablation. Results: No significant differences were observed between P wave parameters observed before and after ablation. Maximum P wave durations (Pmax) and P dispersion (Pdisp) were significantly higher in Group 1 than in Group 2 (P < 0.001 for both) whereas minimum P wave durations did not differ between groups, both before and after ablation. Ten patients (28%) in Group-1 had recurrence of AF during a mean follow-up of 34 ± 11 months. Univariate predictors of AF recurrence were Pdisp ,35.5 ms (P < 0.010), left atrial diameter >40 mm (P < 0.010), mitral or aortic calcification (P < 0.010), Pmax ,112 ms (P < 0.050), valvular heart disease (P < 0.050), and atrial vulnerability (induction of AF lasting >30 second) after ablation (P < 0.050). However, only Pdisp ,35.5 ms (P < 0.050) and left atrial diameter >40 mm (P < 0.010) were independent predictors of AF recurrences. Conclusion: This study suggests that P wave dispersion could identify patients with AVNRT susceptible to recurrence of AF after slow pathway ablation. [source]

Differences in the morphology and duration between premature P waves and the preceding sinus complexes in patients with a history of paroxysmal atrial fibrillation

CLINICAL CARDIOLOGY, Issue 7 2003
Polychronis E. Dilaveris M.D.
Abstract Background: Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Experimental and human mapping studies have demonstrated that perpetuation of AF is due to the presence of multiple reentrant wavelets with various sizes in the right and left atria. Hypothesis: Atrial fibrillation may be induced by atrial ectopic beats originating in the pulmonary veins, and premature P-wave (PPW) patterns may help to identify the source of firing. Methods: To evaluate the morphology and duration of PPWs, 12-lead digital electrocardiogram (ECG) strips containing clearly definable PPWs not merging with the preceding T waves were obtained in 25 patients with AF history (9 men, mean age 59.5 ± 2.2 years) and 25 subjects without any previous AF history (11 men, mean age 53.6 ± 2.5 years). The polarity of PPWs was evaluated in all 12 ECG leads. Previously described indices, such as P maximum, P dispersion (= P maximum ,P minimum), P mean, and P standard deviation were also calculated. Results: Premature P-wave patterns were characterized by more positive P waves in lead V1. All P-wave analysis indices were significantly higher in patients with AF than in controls when calculated in the sinus beat, whereas they did not differ between the two groups when calculated in the PPW. P-wave indices did not differ between the PPW and the sinus P wave in either patients with AF or controls, except for P mean, which was significantly higher in the sinus (110.1 ± 1.7 ms) than in the PPW (100 ± 2 ms) only in patients with AF (p = 0.001). Conclusion: The evaluation of PPW patterns is only feasible in a small percentage of short-lasting digital 12-lead ECG recordings containing ectopic atrial beats. Premature P wave patterns are characterized by more positive P waves in lead V1, which indicates a left atrial origin in the ectopic foci. The observed differences in P-wave analysis indices between patients with AF and controls and between sinus beats and PPWs may be attributed to the presence of electrophysiologic changes in the atrial substrate. [source]