P wave dispersion and P wave duration on SAECG in predicting atrial fibrillation in patients with acute myocardial infarction.

BACKGROUND

Atrial fibrillation (AF) is a frequent complication of acute myocardial infarction (AMI), with reported incidence of 7% to 18%. The incidence of congestive heart failure, in-hospital mortality, and long-term mortality is higher in AMI patients with AF than in AMI patients without AF. P wave duration on signal-averaged ECG (PWD) and P wave dispersion on standard ECG (Pd) are noninvasive markers of intra-atrial conduction disturbances, which are believed to be the main electrophysiological cause of AF.

METHODS

In the present study we investigated prospectively whether P wave duration on SAECG and P wave dispersion on standard ECG can predict development of AF in a group of patients with AMI. One hundred and thirty patients (100 men and 30 women, aged 56.9 +/- 12) with AMI were investigated. PWD, Pd, their clinical and hemodynamic characteristics were collected.

RESULTS

During the observation up to 14 days, 22 patients (16.9%) developed AF. Univariate analysis variables associated with development of AF: age > 65 years, Killip class III-IV, PWD > 125 ms, and Pd > 25 ms. Stepwise logistic regression analysis showed that age > 65 years, PWD > 125 ms, and Pd > 25 ms were independently associated with AF.

CONCLUSIONS

PWD and Pd both measured in a very early period of AMI are useful in predicting AF.