Signal-averaged P-wave Duration Does Not Predict Atrial Fibrillation after Thoracic Surgery 

Abstract

Under the conditions of this study, SAPWD did not differentiate patients who did or did not develop AF after noncardiac thoracic surgery, and therefore its measurement cannot be recommended for the routine evaluation of these patients. Older age continues to be a risk factor for AF after thoracic surgery.

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

“…These parameters have not yet been extensively used in an analogous scenario and thus our results cannot be adequately compared to others, with the unique exception being represented by the work of Amar et al They studied 228 patients and found that P-wave duration, both on signal-averaged and on standard 12-lead ECG, was not associated with the risk of newonset AF after non-cardiac thoracic surgery [11].…”

“…In particular, the potential role of not strictly epidemiologic or clinical parameters, has been explored few times [1,11].…”

Clinical prediction rule for atrial fibrillation after coronary artery bypass grafting

“…Several studies examined whether the preoperative presence of a prolonged P-wave duration may select those patients who are likely to develop postoperative AF. P-wave duration was measured from the standard preoperative ECG in some studies (14,15,(17)(18)(19) or by using a computerized signalaveraging system in other studies (15,16,18,19). The latter technique is expensive, requires 20 min to perform, and is not widely available.…”

“…Atrial fibrillation was defined by an irregularly irregular cardiac rhythm other than sinus confirmed by either ambulatory or 12-lead ECG. Based on extensive review of the literature of risk factors for post-CABG AF, we selected 13 clinical variables that were reported in more than one study that included Ͼ500 patients: age, gender, history of AF, chronic obstructive pulmonary disease, hypertension, prior MI, peripheral vascular disease, diabetes mellitus, preoperative use of beta-blockers, aortic cross-clamp time, cardiopulmonary bypass time, and postoperative MI or low cardiac output and three ECG variables: preoperative heart rate, P-wave duration (Ͼ110 ms), and PR interval (Ͼ180 ms) (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Statistics.…”

“…For ECG characteristics predictive of postoperative AF, equally large studies are lacking. Prolonged P-wave duration, indicating intra-atrial conduction delay, observed by standard or signal-averaged ECG, as well as an increased PR-interval were identified by some (14 -17) but not other investigators (18,19) as indpendent risk factors for postoperative AF. Therefore, our goal was to design a prediction rule for postoperative AF risk using both clinical and ECG variables in a prospective cohort of consecutive patients who had coronary artery bypass grafting (CABG).…”