Document Detail


Evaluation of P wave duration and P wave dispersion in adult patients with secundum atrial septal defect during normal sinus rhythm.
MedLine Citation:
PMID:  12957732     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Paroxysmal atrial arrhythmias especially atrial fibrillation (AF) are frequently encountered in adult patients with atrial septal defect (ASD). Previously it was shown that maximum P wave duration and P wave dispersion in 12-lead surface electrocardiograms are significantly increased in individuals with a history of paroxysmal AF. The aim of this study was to determine whether P maximum and P dispersion in adult patients with ASD and without AF are increased as compared to healthy controls. In addition, the relationship of pulmonary to systemic flow ratio (Qp/Qs) and these P wave indices were investigated. METHODS AND RESULTS: Sixty-two consecutive patients [39 women, 23 men; mean age 33+/-13 years (range 16 to 61 years)] with ostium secundum type ASD and 47 healthy subjects [25 women, 22 men; mean age 36.6+/-9.5 years (range 18 to 50 years)] were investigated. P maximum, P minimum and P dispersion (maximum minus minimum P wave duration) were measured from the 12-lead surface ECG. There were no significant differences with respect to age (P=0.08), gender (P=0.3), heart rate (P=0.3), left atrial diameter (P=0.5) and left ventricular ejection fraction (P=0.3) between patients and controls. Pulmonary artery peak systolic pressure was significantly higher in patients with ASD as compared to controls (P<0.0001). P maximum was significantly longer in patients with ASD as compared to controls (P<0.0001). In addition, P dispersion of the patients was significantly higher than controls (P=0.001). P minimum was not different between groups (P=0.12). Mean Qp/Qs of the patients with ASD was 2.5+/-0.7 (minimum 1.5; maximum 4.1) and found to be significantly correlated with P maximum (r=0.34; P=0.006) and P dispersion (r=0.61; P<0.0001). CONCLUSIONS: Prolongation of P maximum and increased P dispersion could represent mechanical and electrical changes of atrial myocardium in patients with ASD. These changes of atrial myocardium may be more prominent with higher left to right shunt volumes.
Authors:
Umit Guray; Yesim Guray; M Birhan Yýlmaz; Burcu Mecit; Hatice Sasmaz; Sule Korknaz; Emine Kutuk
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  91     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-05     Completed Date:  2004-02-26     Revised Date:  2006-07-12    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  75-9     Citation Subset:  IM    
Affiliation:
Yuksek Ihtisas Hospital, Cardiology, Ankara, Turkey. umitguray@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Atrial Fibrillation / complications,  physiopathology*
Electrocardiography*
Female
Heart Atria / physiopathology*
Heart Conduction System / physiopathology*
Heart Septal Defects, Atrial / complications,  diagnosis*,  physiopathology*
Humans
Male
Middle Aged

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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