Usefulness of prolonged P-wave duration on signal averaged ECG in predicting atrial fibrillation in acute myocardial infarction patients
Marcin Rosiak, Jan Ruta, Halina Bolińska
Med Sci Monit 2003; 9(8): MT85-88
Background:Atrial fibrillation (AF) is a frequent complication of acute myocardial infarction (AMI), with a reported incidence of 7–18%. The incidence of congestive heart failure, in-hospital mortality, and long-term mortality is higher in AMI patients with AF than in those without. P-wave duration (PWD) on Signal-Averaged ECG is a non-invasive marker of intra-atrial conduction disturbances, which are believed to be the main electrophysiological cause of AF.Material/Methods:In the present study we investigated whether PWD can predict development of AF in 130 AMI patients (100 men and 30 women, aged 56.9±12). PWD was recorded, along with clinical and hemodynamic characteristics.Results:During the observation period (up to 21 days) 22 patients (16.9%) developed AF. In univariate analysis the variables associated with development of AF were age>65, Killip class III-IV, and PWD>125 ms. Stepwise logistic regression analysis showed that age>65 and PWD>125 ms were independently associated with AF.Conclusions:PWD measured in a very early period of AMI is a useful tool in predicting AF.
Keywords: Myocardial Infarction - complications