P Wave Dispersion in Hypertensive Patients with Paroxysmal Atrial Fibrillation

• Published in: Pacing and clinical electrophysiology 2000-11, Vol.23 (11P2), p.1859-1862
• Main Authors: ÖZER, NECLA, AYTEMIR, KUDRET, ATALAR, ENVER, SADE, ELIF, AKSÖYEK, SERDAR, ÖVÜNç, KENAN, AçÝL, TAYFUN, NAZLÝ, NASÝH, ÖZMEN, FERHAN, OTO, ALI, KES, SÝRRÝ
• Format: Article
• Language: English
• Subjects: Adult; Aged; Atrial Fibrillation - diagnosis; Atrial Fibrillation - etiology; Atrial Fibrillation - physiopathology; Atrial Function, Left; Cardiac Output; Echocardiography; Electrocardiography; Female; Humans; hypertension; Hypertension - complications; Hypertension - physiopathology; Male; Middle Aged; Multivariate Analysis; P wave dispersion; paroxysmal atrial fibrillation; Risk Assessment; ROC Curve; Sensitivity and Specificity; Ventricular Function, Left
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/j.1540-8159.2000.tb07038.x

It is important to assess the risk of developing paroxysmal atrial fibrillation (PAF) in hypertensive patients since hypertension is a common disorder predisposing to PAF. We sought to determine if patients with hypertension at risk of PAF can be identified while in sinus rhythm by measurements of P wave dispersion. Twelve‐lead surface electrocardiograms were recorded in 44 hypertensive patients with history of PAF (group I, mean age = 60) and in 50 hypertensive patients without history of AF (group II, mean age = 57). The maximum P wave duration, the minimum P wave duration, and P wave dispersion (Pd = Pmax ‐Pmin) were calculated from 12‐lead surface ECGs. Left atrial dimension (LAD) and left ventricular ejection fraction (LVEF) were measured by echocardiography. P wave dispersion was significantly greater in group I than group II (50 ± 12 vs 38 ± 8 ms, P = 0.001). P minimum (75 ± 13 vs 87 ± 11 ms, P = 0.001) and LVEF (0.63 ± 0.05 vs 0.67 ± 0.04, P = 0.03) were significantly lower in group I than group II. However P maximum and LAD were not significantly different in group I than group II (P > 0.05). In univariate analysis, P minimum, P wave dispersion, and LVEF were significant predictors of PAF, whereas only P wave dispersion remained a significant independent predictor of PAF in a multivariate analysis. Measurement of P wave dispersion in sinus rhythm may be a useful noninvasive clinical tool to identify patients with hypertension at risk of developing atrial electrical instability and atrial fibrillation.