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P-wave Dispersion (p-wave + dispersion)

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Medical Sciences100%

Selected Abstracts

Assessment of P-Wave Dispersion on 12-Lead Electrocardiography in Students Who Exercise Regularly

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 5 2008
MUSTAFA YILDIZ M.D.
Background: P-wave dispersion, an electrocardiographic marker, is an independent predictor of atrial fibrillation. P-wave dispersion is associated with inhomogeneous and discontinuous propagation of sinus impulses. The aim of this study was to investigate P-wave dispersion in students who apply for registration to School of Physical Education and Sports. Methods: Totally 984 students (810 boys [mean age: 19.8 ± 2.0 years] and 174 girls [mean age: 19.0 ± 1.8 years]) who applied for registration to School of Physical Education and Sports with a training history of some years were included in the study. P-wave duration was calculated in all 12 leads of the surface electrocardiography, which were simultaneously recorded. The difference between P maximum and P minimum durations was defined as P-wave dispersion. Results: Age, body mass index (BMI), systolic blood pressure, diastolic blood pressure, P-wave maximal duration, and P-wave dispersion were increased in boys as compared with girls. Of age (P = 0.53), systolic blood pressure (P = 0.42), diastolic blood pressure (P = 0.50), pulse pressure (P = 0.73), gender, heart rate, and BMI tested with univariate linear regression analysis in all subjects; only gender (P < 0.001), BMI (P = 0.01), and heart rate (P = 0.02) were associated with P-wave dispersion (F = 5.16, P < 0.001, R2= 0.03). Conclusions: P-wave dispersion was increased in boys as compared with girls who exercise regularly. P-wave dispersion is affected by gender, BMI, and heart rate in healthy students. [source]

Evaluation of the Relationship between Atrial Septal Aneurysm and Cardiac Arrhythmias via P-Wave Dispersion and Signal-Averaged P-Wave Duration

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2010
Onur Sinan Deveci M.D.
Objective: The aim of the study was to investigate the relationship between atrial septal aneurysms (ASAs) and cardiac arrhythmias via signal-averaged P-wave duration (SAPWD) and P-wave dispersion (Pd). Methods: Sixty-six patients with ASA served as the study group (group 1; 28 men and 38 women; mean age, 34 ± 10 years) and 62 healthy volunteers served as the control group (group 2; 29 men and 33 women; mean age, 31 ± 8 years) in the current study. ASAs were diagnosed by transthoracic echocardiography based on the criteria of a minimal aneurysmal base of ,15 mm; and an excursion of ,10 mm. All subjects were evaluated by 24-hour Holter monitoring, 12 lead body surface electrocardiogram for P-wave analysis, and signal-averaged electrocardiogram for P-wave duration (PWD). Results: There was no significant difference between the study and control groups in terms of age, gender, left atrium diameter, and left ventricular ejection fraction. Supraventricular arrhythmias (SVAs) were detected in 29 patients with ASA (43.9%) and 5 controls (8.1%; P < 0.001). The mean Pd in patients with ASA was significantly longer compared to the control group (14.1 ± 8 ms vs 7.0 ± 2.9 ms; P < 0.001). Similarly, the mean SAPWD in group 1 was significantly longer compared to group 2 (127.4 ± 17.6 ms vs 99.8 ± 12.3 ms; P < 0.001). Conclusion: Prolonged SAPWD and Pd were determined to indicate electrical disturbances in the atrial myocardium, and predict the increase in the prevalence of SVA in patients with ASA. Ann Noninvasive Electrocardiol 2010;15(2):157,164 [source]

P-Wave Dispersion: A Novel Predictor of Paroxysmal Atrial Fibrillation

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2001
Polychronis E. Dilaveris M.D.
Background: The prolongation of intraatrial and interatrial conduction time and the inhomogeneous propagation of sinus impulses are well known electrophysiologic characteristics in patients with paroxysmal atrial fibrillation (AF). Previous studies have demonstrated that individuals with a clinical history of paroxysmal AF show a significantly increased P-wave duration in 12-lead surface electrocardiograms (ECG) and signal-averaged ECG recordings. Methods: The inhomogeneous and discontinuous atrial conduction in patients with paroxysmal AF has recently been studied with a new ECG index, P-wave dispersion. P-wave dispersion is defined as the difference between the longest and the shortest P-wave duration recorded from multiple different surface ECG leads. Up to now the most extensive clinical evaluation of P-wave dispersion has been performed in the assessment of the risk for AF in patients without apparent heart disease, in hypertensives, in patients with coronary artery disease and in patients undergoing coronary artery bypass surgery. P-wave dispersion has proven to be a sensitive and specific ECG predictor of AF in the various clinical settings. However, no electrophysiologic study has proven up to now the suspected relationship between the dispersion in the atrial conduction times and P-wave dispersion. The methodology used for the calculation of P-wave dispersion is not standardized and more efforts to improve the reliability and reproducibility of P-wave dispersion measurements are needed. Conclusions: P-wave dispersion constitutes a recent contribution to the field of noninvasive electrocardiology and seems to be quite promising in the field of AF prediction. A.N.E. 2001;6(2):159,165 [source]

Assessment of P-Wave Dispersion on 12-Lead Electrocardiography in Students Who Exercise Regularly

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 5 2008
MUSTAFA YILDIZ M.D.
Background: P-wave dispersion, an electrocardiographic marker, is an independent predictor of atrial fibrillation. P-wave dispersion is associated with inhomogeneous and discontinuous propagation of sinus impulses. The aim of this study was to investigate P-wave dispersion in students who apply for registration to School of Physical Education and Sports. Methods: Totally 984 students (810 boys [mean age: 19.8 ± 2.0 years] and 174 girls [mean age: 19.0 ± 1.8 years]) who applied for registration to School of Physical Education and Sports with a training history of some years were included in the study. P-wave duration was calculated in all 12 leads of the surface electrocardiography, which were simultaneously recorded. The difference between P maximum and P minimum durations was defined as P-wave dispersion. Results: Age, body mass index (BMI), systolic blood pressure, diastolic blood pressure, P-wave maximal duration, and P-wave dispersion were increased in boys as compared with girls. Of age (P = 0.53), systolic blood pressure (P = 0.42), diastolic blood pressure (P = 0.50), pulse pressure (P = 0.73), gender, heart rate, and BMI tested with univariate linear regression analysis in all subjects; only gender (P < 0.001), BMI (P = 0.01), and heart rate (P = 0.02) were associated with P-wave dispersion (F = 5.16, P < 0.001, R2= 0.03). Conclusions: P-wave dispersion was increased in boys as compared with girls who exercise regularly. P-wave dispersion is affected by gender, BMI, and heart rate in healthy students. [source]

Evaluation of the Relationship between Atrial Septal Aneurysm and Cardiac Arrhythmias via P-Wave Dispersion and Signal-Averaged P-Wave Duration

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2010
Onur Sinan Deveci M.D.
Objective: The aim of the study was to investigate the relationship between atrial septal aneurysms (ASAs) and cardiac arrhythmias via signal-averaged P-wave duration (SAPWD) and P-wave dispersion (Pd). Methods: Sixty-six patients with ASA served as the study group (group 1; 28 men and 38 women; mean age, 34 ± 10 years) and 62 healthy volunteers served as the control group (group 2; 29 men and 33 women; mean age, 31 ± 8 years) in the current study. ASAs were diagnosed by transthoracic echocardiography based on the criteria of a minimal aneurysmal base of ,15 mm; and an excursion of ,10 mm. All subjects were evaluated by 24-hour Holter monitoring, 12 lead body surface electrocardiogram for P-wave analysis, and signal-averaged electrocardiogram for P-wave duration (PWD). Results: There was no significant difference between the study and control groups in terms of age, gender, left atrium diameter, and left ventricular ejection fraction. Supraventricular arrhythmias (SVAs) were detected in 29 patients with ASA (43.9%) and 5 controls (8.1%; P < 0.001). The mean Pd in patients with ASA was significantly longer compared to the control group (14.1 ± 8 ms vs 7.0 ± 2.9 ms; P < 0.001). Similarly, the mean SAPWD in group 1 was significantly longer compared to group 2 (127.4 ± 17.6 ms vs 99.8 ± 12.3 ms; P < 0.001). Conclusion: Prolonged SAPWD and Pd were determined to indicate electrical disturbances in the atrial myocardium, and predict the increase in the prevalence of SVA in patients with ASA. Ann Noninvasive Electrocardiol 2010;15(2):157,164 [source]

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 Indices, Distribution and Quality Control Assessment (from the Framingham Heart Study)

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 1 2010
Jared W. Magnani M.D.
Background: P-wave indices of maximum P-wave duration and P-wave dispersion have been examined in a broad array of cardiovascular and noncardiovascular disease states. The P-wave indices literature has been highly heterogeneous in measurement methodologies, described quality control metrics, and distribution of values. We therefore sought to determine the reproducibility of P-wave indices in a community-based cohort. Methods: P-wave indices were measured in sequential subjects enrolled in the Framingham Heart Study. Electrocardiograms were obtained at the 11th biennial visit of the Original Cohort (n = 250) and the initial visit of the Offspring Cohort (n = 252). We determined the mean P-wave durations, interlead correlations, and P-wave indices. We then chose 20 ECGs, 10 from each cohort, and assessed intrarater and interrater variability. Results: The maximum P-wave duration ranged from 71 to 162 ms with mean of 112 ± 12 ms. The minimum P-wave duration ranged from 35 to 103 ms with mean of 65 ± 10 ms. P-wave dispersion ranged from 12 to 82 ms. The mean P-wave dispersion was 48 ± 12 ms (40,56). The intrarater intraclass correlation coefficient (ICC) was r = 0.80 for maximum P-wave duration and r = 0.82 for P-wave dispersion. The interrater ICC was 0.56 for maximum P-wave duration and 0.70 for P-wave dispersion. Conclusions: We demonstrated excellent intrarater reproducibility and fair interrater reproducibility for calculating P-wave indices. Reproducibility is frequently lacking in studies of P-wave indices, but is an essential component for the field's growth and epidemiologic contribution. Ann Noninvasive Electrocardiol 2010;15(1):77,84 [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]

Increases in P-Wave Duration and Dispersion After Hemodialysis Are Totally (or Partially) Due to the Procedure-Induced Alleviation of the Body Fluid Overload: A Hypothesis with Strong Experimental Support

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2005
John E. Madias M.D.
Increases in the P-wave duration (P-du) and P-wave dispersion (P-d) following hemodialysis (HD) are attributed to changes in the electrolytic milieu with HD, or are considered to be due to an unknown mechanism. Such changes are thought to be proarrhythmic, and thus have potential clinical implications. Increase in the amplitude of QRS complexes following HD has been amply documented in the literature. Also, recent work linking attenuation/augmentation of amplitude of QRS and P-wave complexes in patients with increase/subsequent decrease weights due to anasarca peripheral edema/and its alleviation, or before/after hemodialysis (HD) suggests that the increase in the P-du and P-d after HD may be totally (or partially) mediated by the alleviation of the fluid overload by the procedure. This is supported by the decrease/increase in the QRS duration noted with anasarca/and its alleviation. To further clarify this issue, and prove or refute the above hypothesis, it is recommended that correlations of changes in the P-du and P-d with the loss of weight or net fluid dialyzed are carried out, in addition to the traditional considerations of electrolytic alterations after HD. [source]

P-Wave Dispersion: A Novel Predictor of Paroxysmal Atrial Fibrillation

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2001
Polychronis E. Dilaveris M.D.
Background: The prolongation of intraatrial and interatrial conduction time and the inhomogeneous propagation of sinus impulses are well known electrophysiologic characteristics in patients with paroxysmal atrial fibrillation (AF). Previous studies have demonstrated that individuals with a clinical history of paroxysmal AF show a significantly increased P-wave duration in 12-lead surface electrocardiograms (ECG) and signal-averaged ECG recordings. Methods: The inhomogeneous and discontinuous atrial conduction in patients with paroxysmal AF has recently been studied with a new ECG index, P-wave dispersion. P-wave dispersion is defined as the difference between the longest and the shortest P-wave duration recorded from multiple different surface ECG leads. Up to now the most extensive clinical evaluation of P-wave dispersion has been performed in the assessment of the risk for AF in patients without apparent heart disease, in hypertensives, in patients with coronary artery disease and in patients undergoing coronary artery bypass surgery. P-wave dispersion has proven to be a sensitive and specific ECG predictor of AF in the various clinical settings. However, no electrophysiologic study has proven up to now the suspected relationship between the dispersion in the atrial conduction times and P-wave dispersion. The methodology used for the calculation of P-wave dispersion is not standardized and more efforts to improve the reliability and reproducibility of P-wave dispersion measurements are needed. Conclusions: P-wave dispersion constitutes a recent contribution to the field of noninvasive electrocardiology and seems to be quite promising in the field of AF prediction. A.N.E. 2001;6(2):159,165 [source]

The comparative effects of telmisartan and ramipril on P-wave dispersion in hypertensive patients: A randomized clinical study

CLINICAL CARDIOLOGY, Issue 6 2005
Turgay Celik M.D.
Abstract Background: Prolongation of P-wave times and increase of P-wave dispersion (PWD) were shown to be independent predictors of atrial fibrillation (AF). Angiotensin II receptor blockers (AARBs) and angiotensin-converting enzyme inhibitors (ACEIs) have beneficial effects on atrial conduction times. However, there are not enough data about the comparative effects of those drugs onPWD. Hypothesis: We aimed to compare the effects of telmisartan and ramipril on PWD after 6-month treatment in hypertensive patients. Methods: In all, 100 newly diagnosed hypertensive patients were enrolled in the study and were randomly assigned to two groups. Group 1 and Group 2 each consisted of 50 patients, taking daily doses of 80 mg telmisartan and 10 mg ramipril, respectively. Twelve-lead surface electrocardiograms (ECG) were recorded from all patients before and after 6-month drug therapy. The P-wave duration (Pdur) measurements were calculated from the 12-lead surface ECG. Results: When pretreatment PWD and P maximum values were compared with post-treatment values, a statistically significant decrease was found in both groups after 6 months (Group 1 and 2; p < 0.001 for PWD and Pmaximum). P-wave dispersion and Pmaximum values after treatment in Group 1 were statistically significantly lower than those in Group 2 after the 6-month treatment period (p = 0.01 for PWD; p = 0.008 for Pmaximum). Conclusions: Telmisartan has a much greater lowering effect on PWD and Pmaximum values than ramipril. This finding may be important in the prevention of AF in hypertensive patients. [source]