Document Detail

P-wave dispersion for predicting paroxysmal atrial fibrillation in acute ischemic stroke.
MedLine Citation:
PMID:  22211098     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Detection of paroxysmal atrial fibrillation (PAF) in acute ischemic stroke patients poses diagnostic challenge. The aim of this study was to predict the presence of PAF by means of 12-lead ECG in patients with acute ischemic stroke. Our hypothesis was that P-wave dispersion (P(d)) might be a useful marker in predicting PAF in patients with acute ischemic stroke.
METHODS: 12-lead resting ECGs, 24-hour Holter recordings and echocardiograms of 400 patients were analyzed retrospectively. PAF was detected in 40 patients on 24-hour Holter monitoring. Forty out of 360 age and gender matched patients without PAF were randomly chosen and assigned as the control group. Demographics, P-wave characteristics and echocardiographic findings of the patients with and without PAF were compared.
RESULTS: Maximum P-wave duration (p=0.002), P(d) (p<0.001) and left atrium diameter (p=0.04) were significantly higher in patients with PAF when compared to patients without PAF. However, in binary logistic regression analysis P(d) was the only independent predictor of PAF. The cut-off value of P(d) for the detection of PAF was 57.5 milliseconds (msc). Area under the curve was 0.80 (p<0.001). On a single 12-lead ECG, a value higher than 57.5 msc predicted the presence of PAF with a sensitivity of 80% and a specificity of 73%.
CONCLUSION: P(d) on a single 12-lead ECG obtained within 24 hours of an acute ischemic stroke might help to predict PAF and reduce the risk of recurrent strokes.
Umuttan Dogan; Ebru Apaydin Dogan; Mehmet Tekinalp; Osman Serhat Tokgoz; Alpay Aribas; Hakan Akilli; Kurtulus Ozdemir; Hasan Gok; Betigul Yuruten
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Publication Detail:
Type:  Journal Article     Date:  2011-12-17
Journal Detail:
Title:  International journal of medical sciences     Volume:  9     ISSN:  1449-1907     ISO Abbreviation:  Int J Med Sci     Publication Date:  2012  
Date Detail:
Created Date:  2012-01-02     Completed Date:  2012-06-19     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  101213954     Medline TA:  Int J Med Sci     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  108-14     Citation Subset:  IM    
Selcuk University, Meram School of Medicine, Cardiology Department, Meram, Konya, 42080, Turkey.
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MeSH Terms
Aged, 80 and over
Atrial Fibrillation / physiopathology,  ultrasonography*
Electrocardiography, Ambulatory / methods
Heart Atria / physiopathology*,  ultrasonography*
Logistic Models
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Factors
Sensitivity and Specificity
Stroke / physiopathology*,  ultrasonography*

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