Increased P‐Wave Duration and P‐Wave Dispersion in Patients with Aortic Stenosis

Turhan, Hasan; Yetkın, Ertan; Atak, Ramazan; Altinok, Tayfun; Şenen, Kubilay; İleri, Mehmet; Şaşmaz, Hatice; Çehreli, Şengül; Kütük, Emine

doi:10.1046/j.1542-474x.2003.08104.x

Cited by 42 publications

(39 citation statements)

References 20 publications

(23 reference statements)

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“…The identification of predictive factors associated with the risk for AF has been a general concern since the Framingham study, and several factors have been associated with a higher incidence of AF in the general population (18,(25)(26)(27)(28)(29)(30). In the present study, the prevalence of systemic arterial hypertension did not differ across Los Andes groups on admission (Table 1) and neither the distribution of systemic hypertension nor drug therapy to control blood pressure among subjects who experienced and did not experience AF was statistically different at the end of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Mechanical cardiac remodeling and new-onset atrial fibrillation in long-term follow-up of subjects with chronic Chagas' disease

Benchimol-Barbosa

Barbosa-Filho

2009

Braz J Med Biol Res

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Atrial fibrillation (AF) affects subjects with Chagas' disease and is an indicator of poor prognosis. We investigated clinical, echocardiographic and electrocardiographic variables of Chagas' disease in a long-term longitudinal study as predictors of a new-onset AF episode lasting >24 h, nonfatal embolic stroke and cardiac death. Fifty adult outpatients (34 to 74 years old, 62% females) staged according to the Los Andes classification were enrolled. During a follow-up of (mean ± SD) 84.2 ± 39.0 months, 9 subjects developed AF (incidence: 3.3 ± 1.0%/year), 5 had nonfatal stroke (incidence: 1.3 ± 1.0%/year), and nine died (mortality rate: 2.3 ± 0.8%/year). The progression rate of left ventricular mass and left ventricular ejection fraction was significantly greater in subjects who experienced AF (16.4 ± 20.0 g/year and -8.6 ± 7.6%/year, respectively) than in those who did not (8.2 ± 8.4 g/year; P = 0.03, and -3.0 ± 2.5%/year; P = 0.04, respectively). In univariate analysis, left atrial diameter ≥3.2 cm (P = 0.002), pulmonary arterial hypertension (P = 0.035), frequent premature supraventricular and ventricular contraction counts/ 24 h (P = 0.005 and P = 0.007, respectively), ventricular couplets/24 h (P = 0.002), and ventricular tachycardia (P = 0.004) were long-term predictors of AF. P-wave signal-averaged ECG revealed a limited long-term predictive value for AF. In chronic Chagas' disease, large left atrial diameter, pulmonary arterial hypertension, frequent supraventricular and ventricular premature beats, and ventricular tachycardia are long-term predictors of AF. The rate of left ventricular mass enlargement and systolic function deterioration impact AF incidence in this population.

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Section: Discussionmentioning

confidence: 99%

Mechanical cardiac remodeling and new-onset atrial fibrillation in long-term follow-up of subjects with chronic Chagas' disease

Benchimol-Barbosa

Barbosa-Filho

2009

Braz J Med Biol Res

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“…Moreover, the link between the presence of intra-atrial conduction abnormalities and the induction of paroxysmal AF has been well described [16]. P-wave dispersion is a new ECG parameter that has been associated with the inhomogeneous and discontinuous propagation of sinus impulse; it has already been tested to predict AF in various clinical settings [17,18]. The role of P-wave features in predicting episodes of postoperative AF are less clear because of conflicting results and since they have been almost exclusively used in the context of cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Atrial fibrillation after non-cardiac surgery: P-wave characteristics and Holter monitoring in risk assessment☆

Materazzo¹,

Piotti²,

Mantovani³

et al. 2007

European Journal of Cardio-Thoracic Surgery

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“…[1][2][3] Moreover, aortic stenosis is associated with chronic AF. 4,5 However, the mechanisms underlying the relation between elevated afterload and the development of AF remain unclear.…”

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confidence: 99%

Atrial Remodeling and the Substrate for Atrial Fibrillation in Rat Hearts With Elevated Afterload

Kim

Choisy

Barman

et al. 2011

Circ: Arrhythmia and Electrophysiology

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Background-Although arterial hypertension and left ventricular hypertrophy are considered good epidemiological indicators of the risk of atrial fibrillation (AF) in patients, the link between elevated afterload and AF remains unclear. We investigated atrial remodeling and the substrate for arrhythmia in a surgical model of elevated afterload in rats. Methods and Results-Male Wistar rats (aged 3-4 weeks) were anesthetized and subjected to either partial stenosis of the ascending aorta (AoB) or sham operation (Sham). Experiments were performed on excised hearts 8, 14, and 20 weeks after surgery. Unipolar electrograms were recorded from the left atrial epicardial surface of perfused hearts using a 5ϫ5 electrode array. Cryosections of left atrial tissue were retained for histological and immunocytochemical analyses.

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Increased P‐Wave Duration and P‐Wave Dispersion in Patients with Aortic Stenosis

Abstract: PWD, indicating increased risk for paroxysmal AF, was found to be significantly higher in patients with AS than in those without it. Further assessment of the clinical utility of PWD for the prediction of paroxysmal AF in patients with severe AS will require longer prospective studies.

Cited by 42 publications

References 20 publications

Mechanical cardiac remodeling and new-onset atrial fibrillation in long-term follow-up of subjects with chronic Chagas' disease

Mechanical cardiac remodeling and new-onset atrial fibrillation in long-term follow-up of subjects with chronic Chagas' disease

Atrial fibrillation after non-cardiac surgery: P-wave characteristics and Holter monitoring in risk assessment☆

Atrial Remodeling and the Substrate for Atrial Fibrillation in Rat Hearts With Elevated Afterload

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