Lelakowska-Pieła Maria, Pudło Joanna, Engel Anna, Lelakowski Jacek
Studenckie Koło Naukowe przy Klinice Elektrokardiologii.
Uniwersytet Jagielloński, Instytut Kardiologii, Klinika Elektrokardiologii, Krakowski Szpital Specjalistyczny im. Jana Pawła II.
Pol Merkur Lekarski. 2013 Nov;35(209):259-62.
Some findings in standard electrocardiogram (ECG) may be associated with paroxysmal atrial fibrillation (AF). The aim of the study was to evaluate P wave duration and P wave dispersion (Pdysp) derived from 12-lead standard surface ECG in sinus rhythm in patients with history of AF in comparison to control subjects without AF and with premature ventricular ectopic beats (PVEB).
The study group consisted of 20 patients (pts), 9M. 11F, mean age 47.6 +/- 5.5 years with paroxysmal AF. The control group consisted of 19 pts, 9M, 10F, mean age 46.7 +/- 4.7 years without history of AF with PVEB. All patients in both groups were treated with antiarrhythmic drugs. Left atrium dimensions (LA) in the transthoracic echocardiographic examinations (TTE) and maximal (P(max)), minimal (P(min)) wave duration and P(dysp) in a ECG recordings were analyzed. Pdysp was calculated as the difference between P(max) and P(min).
ECG analysis showed statistically significant differences, study group vs control group in P wave duration and P(dysp). We found that in AF group P(max) and P(dysp) were significantly greater (125.5 vs. 114.5 ms, p < 0.005 and 59.5 vs 45.4 ms, p < 0.01, respectively). LA were significantly greater in AF group (43.7 vs 41.8 mm, p < 0.05). P(dysp) correlated significantly with P(mex) and LA.
In AF patients, P wave duration and P wave dispersion, in other words atrial depolarization/repolarization inhomogeneity, were increased. A significant positive correlation between P wave dispersion and both Pmax and left atrium size were found.
标准心电图(ECG)中的一些发现可能与阵发性心房颤动(AF)有关。本研究的目的是评估有房颤病史患者在窦性心律时从12导联标准体表心电图得出的P波时限和P波离散度(Pdysp),并与无房颤且有室性早搏(PVEB)的对照组受试者进行比较。
研究组由20例患者组成,9例男性,11例女性,平均年龄47.6±5.5岁,患有阵发性房颤。对照组由19例患者组成,9例男性,10例女性,平均年龄46.7±4.7岁,无房颤病史但有室性早搏。两组所有患者均接受抗心律失常药物治疗。分析经胸超声心动图检查(TTE)中的左心房大小(LA)以及心电图记录中的最大(P(max))、最小(P(min))波时限和P(dysp)。Pdysp计算为P(max)与P(min)之间的差值。
心电图分析显示,研究组与对照组在P波时限和P(dysp)方面存在统计学显著差异。我们发现,房颤组的P(max)和P(dysp)显著更大(分别为125.5对114.5毫秒,p<0.005;59.5对45.4毫秒,p<0.01)。房颤组的LA显著更大(43.7对41.8毫米,p<0.05)。P(dysp)与P(mex)和LA显著相关。
在房颤患者中,P波时限和P波离散度,即心房去极化/复极化的不均匀性增加。发现P波离散度与Pmax和左心房大小均呈显著正相关。