Boriani Giuseppe, Diemberger Igor, Biffi Mauro, Camanini Claudia, Valzania Cinzia, Corazza Ivan, Martignani Cristian, Zannoli Romano, Branzi Angelo
Institute of Cardiology, University of Bologna, Azienda Ospedaliera S. Orsola-Malpighi, Italy.
Int J Cardiol. 2005 Jun 8;101(3):355-61. doi: 10.1016/j.ijcard.2004.03.039.
P wave dispersion has been previously suggested as a potential tool for predicting the risk of recurrence of atrial fibrillation after electrical cardioversion. We investigated whether different P wave dispersion values are associated with recurrence of atrial fibrillation in the short (< or =1 month after cardioversion) and longer term.
In 37 patients with long-lasting persistent atrial fibrillation (mean duration 21 +/- 36 months) with (n = 19) or without (n = 18) amiodarone pretreatment as antiarrhythmic prophylaxis, maximum and minimum P wave duration and P wave dispersion were measured 1 min after internal cardioversion.
P wave dispersion was lower in patients with amiodarone pretreatment (28.3 +/- 9.5 vs. 21.9 +/- 7.3 ms, P = 0.029). The subgroups of patients with recurrence of atrial fibrillation at 1 month or in the long-term did not differ from the rest of the study sample regarding age, sex, atrial fibrillation duration, left atrial dimensions or ejection fraction. P wave dispersion was significantly higher in patients with short-term atrial fibrillation recurrence (< or = 1 month) than in the rest of the population. Furthermore, P wave dispersion values >25 ms were associated with a higher short-term relapse rate. No significant relation was present in the long-term.
Our results suggest that P wave dispersion analysis immediately after internal cardioversion may help predict short-term recurrences of atrial fibrillation. These findings may be related to different mechanisms and predisposing factors for short-term and late recurrences. The long-term predictive value of serial evaluations of P wave dispersion during follow-up deserves investigation.
P波离散度先前已被认为是预测电复律后房颤复发风险的一种潜在工具。我们研究了不同的P波离散度值是否与房颤在短期（复律后≤1个月）和长期的复发相关。
对37例长期持续性房颤患者（平均病程21±36个月）进行研究，其中19例患者在复律前接受胺碘酮预处理作为抗心律失常预防措施，18例未接受预处理。在体内复律后1分钟测量最大和最小P波时限及P波离散度。
接受胺碘酮预处理的患者P波离散度较低（28.3±9.5 vs. 21.9±7.3 ms，P = 0.029）。在1个月或长期发生房颤复发的患者亚组，在年龄、性别、房颤病程、左房大小或射血分数方面与研究样本的其余部分无差异。短期房颤复发（≤1个月）患者的P波离散度显著高于其余人群。此外，P波离散度值>25 ms与较高的短期复发率相关。长期则无显著相关性。
我们的结果表明，体内复律后立即进行P波离散度分析可能有助于预测房颤的短期复发。这些发现可能与短期和晚期复发的不同机制及易感因素有关。随访期间连续评估P波离散度的长期预测价值值得研究。
