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Abstract: Objective: To comparatively evaluate P-wave dispersion (PWD) in patients with β-thalassemia major (TM) and healthy control subjects for the early prediction of arrhythmia risk.Methods: Eighty-one children with β-TM, aged 4-19 years, and 74 healthy children (control group) underwent routine electrocardiography and transthoracic echocardiography for cardiac evaluation. PWD was calculated as the difference between the maximum and the minimum P-wave duration.Results: There was a statistically significant differenc… Show more

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“…In literature, there are few studies about the electrocardiographic markers for the early detection of cardiac disease in patients with b-TM [31][32][33][34]. Nisli et al [13] showed an increased PD in b-TM children and supposed it could be related to depression of intra-atrial conduction due to atrial dilatation and increased sympathetic activity; however, their study presented some limitations: the restrictive diastolic filling pattern of b-TM patients and the lack evaluation of atrial dimension and iron deposition by cardiac magnetic resonance or tissue Doppler imaging. Myocardial iron content cannot be predicted from serum ferritin or liver iron, and conventional assessments of cardiac function can only detect those with advanced disease.…”
Section: Discussionmentioning
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“…In literature, there are few studies about the electrocardiographic markers for the early detection of cardiac disease in patients with b-TM [31][32][33][34]. Nisli et al [13] showed an increased PD in b-TM children and supposed it could be related to depression of intra-atrial conduction due to atrial dilatation and increased sympathetic activity; however, their study presented some limitations: the restrictive diastolic filling pattern of b-TM patients and the lack evaluation of atrial dimension and iron deposition by cardiac magnetic resonance or tissue Doppler imaging. Myocardial iron content cannot be predicted from serum ferritin or liver iron, and conventional assessments of cardiac function can only detect those with advanced disease.…”
Section: Discussionmentioning
“…In previous studies, it was shown that PD prolongation is an independent risk factor for development of atrial fibrillation (AF) [11,12]. To our knowledge, little is still known about the influence of b-TM on PD [13]. The aim of our study was to evaluate the PD in b-TM patients with conserved systolic and diastolic functions.…”
Section: Introductionmentioning
“…The generally accepted cut-off value for the Pd is above 40 ms, and for the P max it is above 120 ms of duration, and these values may predict AF development (16,19). Previously, prolongation of Pd in β-TM patients was described by Nisli et al (13), where an increased Pd was related to the depression of intra-atrial conduction due to atrial dilatation and increased sympathetic tone. However, their study did not evaluate diastolic functions and iron deposits using the cardiac T2*MRI, which may contribute to prolonged Pd.…”
Section: Discussionmentioning
“…Neither Pi nor IAB, reliable and novel markers of P wave abnormality, were examined in patients with β-TM. On the other hand, only two small studies have found increased Pd in patients with β-TM where Russo et al (12) have assessed the relationship between Pd and myocardial iron deposit as assessed by cardiac T2* magnetic resonance imaging (MRI) (12)(13).…”
Section: Introductionmentioning
“…7 In another study, β-thalassemia major patients, secondary to increased sympathetic activation and atrial dilatation, as a result of intra-atrial conduction delay, prolonged P-wave dispersion has been reported. 8 Ventricular arrhythmias, atrial arrhythmias in patients with thalassemia are rare and usually more resistant to antiarrhythmic therapy. Isma'eel et al, the incidence of ventricular late potentials on signal averaged ECG in patients with thalassemia is more than the normal individuals were determined.…”
Section: Discussionmentioning