Prevalence of P wave dispersion and interatrial block in patients with systolic heart failure and their relationship with functional status, hospitalization and one year mortality

Abstract

Background and objectivesP-wave dispersion (PWD) and Interatrial block (IAB) are common in heart failure (HF), and could be associated with adverse cardiac events. We aimed to assess the prevalence of PWD and IAB and their relationship with functional status, hospitalization and mortality rate in patients with systolic HF.MethodsWe enrolled 110 HF patients in sinus rhythm & LVEF <50%. Patients had undergone clinical evaluation, 6 min walking test (6MWT), 12-lead electrocardiography (ECG), 24-h Holter ECG & echocardiogram. Hospitalization and mortality rate were followed-up for one year. PWD was defined as the difference between maximum & minimum P-wave duration >40 ms. IAB was defined as maximum P duration >110 ms. Measurements were done by 2 blinded investigators using a caliber, a ruler and a magnifying lens.ResultsMean age was 58.9 ± 9.7 years and 67.3% were males. Prevalence of PWD and IAB was 68.2% and 57.3%, respectively. Patients with PWD showed these features: 84% in NYHA class III or IV HF, 77.4% had LVEF <35%, 78.7% had paroxysmal Atrial Fibrillation (AF) and 89.4% couldn’t complete >200 m (m) in 6MWT. Patients with PWD had more hospitalizations (72% vs 28.6%, P value <0.02) and higher 1-year mortality rate (20% vs 8.6%, P value <0.04) than patients without PWD. Likewise, patients with IAB had nearly similar clinical features, hospitalization and mortality as patients with PWD.ConclusionPWD and IAB are prevalent in patients with systolic HF and they are significantly associated with low LVEF, paroxysmal AF, poor functional capacity, hospitalization and mortality rate.

P‐wave durations from automated electrocardiogram analysis to predict atrial fibrillation and mortality in heart failure

“…Moreover, prolongations in amplified PWDs were predictive of new‐onset AF in patients with HF with preserved ejection fraction 33 . Similar findings have been observed in the context of HF with reduced ejection fraction 34 . These findings are in keeping with prolonged total atrial conduction time, which reflects atrial remodelling, with poorer cardiac prognosis in HF 35 …”

“…33 Similar findings have been observed in the context of HF with reduced ejection fraction. 34 These findings are in keeping with prolonged total atrial conduction time, which reflects atrial remodelling, with poorer cardiac prognosis in HF. 35 Recent studies have explored the use of automated ECG indices for risk prediction in different cardiovascular diseases.…”

ST-segment elevasyonlu akut miyokard infarktüsü ile başvuran hastalarda interatrial ileti bozuklukları

“…IAB is also a frequent accompanying abnormality in patients with heart failure. Abdellah et al (12) evaluated the frequency and clinical associates of IAB in patients with systolic heart failure. They found that patients with IAB had significantly higher functional classes and increased mortality during 12-month follow up period.…”

Interatrial blocks prevalence and risk factors for human immunodeficiency virus-infected persons

“…The clinical relevance of this study is yet to be determined. In the last few years, increasing evidence about the impact of IAB on clinical outcomes, including hospital admissions, poor functional capacity, and mortality has been published [26]; however, until now, there are no recommendations for the follow-up or treatment of these patients so it remains to be seen how identifying patients with IAB could benefit their health. In the case of PLWH (who are considered at higher cardiovascular risk than uninfected people), the global rapid increase in mortality due to cardiovascular events requires a more proactive approach in implementing prevention strategies that could aim for lessening the burden of disease.…”