Document Detail


Prediction of conversion from paroxysmal to permanent atrial fibrillation.
MedLine Citation:
PMID:  17338722     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Paroxysmal atrial fibrillation (PAF) transits to permanent atrial fibrillation (PEAF). The current study was to determine whether a P wave-triggered P wave signal averaged electrocardiogram (P-SAECG) and chemoreflexsensitivity (CHRS) are useful to predict a conversion to PEAF in patients with PAF.
METHODS: The filtered P wave duration (FPD) and the root mean square voltage of the last 20 ms of the P wave (RMS 20) were measured by P-SAECG. The ratio between the difference of RR intervals in the ECG and venous pO2 before and after 5-minutes oxygen inhalation is measured (ms/mmHg) for the determination of CHRS.
RESULTS: A total of 180 patients with PAF were enrolled and followed for a mean of 22.5 months. PEAF occurred in 38 patients (21%) and these patients had a significantly larger left atrial size (43.2 +/- 4.9 vs. 41.0 +/- 5.4 mm, P = 0.021), a significantly longer FPD (158.8 +/- 18.2 vs. 136.7 +/- 16.6 ms, P < 0.0001), and a significantly lower CHRS (1.96 +/- 0.99 vs. 2.44 +/- 1.19 ms/mmHg, P = 0.024) than patients with PAF. Patients with PEAF tended to have a lower RMS 20 (2.38 +/- 0.65 vs. 2.75 +/- 1.18 microV, P = 0.067) than patients with PAF. The chi(2) test showed that the combination of FPD > or = 145 ms, RMS 20 < or = 3.0 microV, left atrial size > or = 41 mm, and CHRS < or = 2.0 ms/mmHg had the best predictive power for PEAF. Patients who fulfilled these criteria had a 12-fold increased risk for a conversion from PAF to PEAF.
CONCLUSIONS: Our results show that a P-SAECG, an analysis of CHRS, and left atrial enlargement are clinical predictors of a progression from PAF to PEAF.
Authors:
Marco Budeus; Oliver Felix; Marcus Hennersdorf; Heinrich Wieneke; Raimund Erbel; Stefan Sack
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  30     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-03-06     Completed Date:  2007-05-01     Revised Date:  2014-07-29    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  243-52     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Algorithms*
Atrial Fibrillation / classification,  diagnosis*
Chemoreceptor Cells*
Diagnosis, Computer-Assisted / methods*
Electrocardiography / methods*
Female
Humans
Male
Middle Aged
Prognosis
Reflex*
Reproducibility of Results
Sensitivity and Specificity

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


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