Document Detail

Dynamic changes of P-wave duration and P-wave axis during head-up tilt test in patients with vasovagal syncope.
MedLine Citation:
PMID:  16884510     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The exact role of venous pooling in the pathogenesis of vasovagal syncope (VVS) is not fully elucidated. P-wave duration on an electrocardiogram can serve as a measure of atrial volume. METHODS: Sixty-six patients (15 men, 51 women, mean age 32 years) with unexplained syncope were enrolled in the study.P-wave duration and the P-wave axis (PWA) were measured during passive head-up tilt test (HUT) in order to evaluate dynamic changes of atrial filling in patients with VVS. RESULTS: HUT was positive in 40 patients (6 men, 34 women, mean age 32 +/- 9 years) and negative in 26 patients (9 men, 17 women, mean age 33 +/- 8 years). The P-wave duration was significantly reduced in HUT-positive patients at the onset of symptoms as compared to 5 minutes (88.8 +/- 11.9 vs 96.2 +/- 12.0 ms, P = 0.008), and baseline (88.8 +/- 11.9 vs 96.8 +/- 13.8 ms, P = 0.005). The P-wave duration was significantly shorter at the onset of presyncope in HUT-positive patients as compared to HUT-negative patients (88.8 +/- 11.9 vs 100.3 +/- 11.2 ms, P = 0.0002). In HUT-positive patients, a significant increase in PWA was found at the onset of symptoms when compared to baseline (67.7 +/- 22.1 degrees vs 47.9 +/- 14.9 degrees, P < 0.0001) and 5 minutes of HUT (67.7 +/- 22.1 degrees vs 54.4 +/- 14.9 degrees, P = 0.005). At the time of syncope, PWA was more inferior in HUT-positive patients than in HUT-negative patients (67.7 +/- 22.1 degrees vs 51.8 +/- 13.8 degrees, P = 0.015). CONCLUSIONS: VVS is associated with the reduction in P-wave duration and the increase in PWA, which can be a result of exaggerated venous pooling and reduction in atrial volume.
Peter Mitro; Ján Spegár
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  29     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-08-03     Completed Date:  2006-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  742-6     Citation Subset:  IM    
Clinic of Internal Medicine III, Medical Faculty of P.J. Safarik University, Kosice, Slovakia.
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MeSH Terms
Analysis of Variance
Heart Conduction System / physiopathology*
Syncope, Vasovagal / physiopathology*
Tilt-Table Test*

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