Increased P wave duration and dispersion is associated with catheter-related atrial fibrillation during electrophysiological study

Year 2019, Volume: 5 Issue: 4, 691 - 696, 04.07.2019

Yahya Kemal İçen , Hilmi Erdem Sümbül , Mevlüt Koç

https://doi.org/10.18621/eurj.412058

Abstract

Objectives:
Catheter-related atrial fibrillation (AF) is a common cause during
electrophysiological study (EPS) and prolongs the duration of the
procedure.  In our study, we compared P
wave duration and dispersion in patients with and without catheter-related
atrial fibrillation during EPS.

Methods: One
hundred forty five patients who had normal EPS findings and who were found to
have catheter related atrial fibrillation were included in our study.
Electrocardiogram was performed in all patients and the pulse rate, the longest
P wave duration (Pmax), the shortest P wave duration (Pmin) and the difference
between of those (P wave dispersion: Pdisp) were recorded. EPS was performed in
all patients. The patients were divided into two groups as the group 1 (without
catheter-related AF) and group 2 (with catheter-related AF).

Results: In group
2, EPS time was significantly longer, Pmax and Pdisp were found to be
significantly higher, Pmin was found to be significantly lower. Binominal logistic
regression analysis revealed that, Pmax (OR: 1.077, 95% CI: 1.043-1.112, p < 0.001), Pmin (OR: 0.889, 95% CI: 0.853-926,
p < 0.001) and Pdisp (OR: 1.125, 95%
CI: 1.080-1.173, p < 0.001) were
all independent predictors for catheter-related AF. In ROC analyses, Pmax cut-off
value of 120 ms determined the catheter-related AF with 61% sensitivity and 67%
specificity, Pdisp cut-off value of 35 ms determined the catheter-related AF
with 80% sensitivity and 71% specificity.

Conclusion: Patients
with longer Pdisp and Pmax and shorter Pmin may develop catheter-related AF
during EPS. 

Keywords

Atrial fibrillation, P wave dispersion, electrophysiological study

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