Demirtas Abdullah Orhan, Icen Yahya Kemal, Donmez Yurdaer, Koca Hasan, Kaypakli Onur, Koc Mevlut
Cardiology Department, Health Sciences University, Adana City Hospital, Adana, Turkey.
Cardiology Department, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.
Arch Med Sci Atheroscler Dis. 2019 May 27;4:e74-e81. doi: 10.5114/amsad.2019.85375. eCollection 2019.
Atrial fibrillation (AF) attacks can be silent, symptomatic, or emerge with its complications in pacemaker-implanted patient groups. P-wave duration index (PWDI), a novel parameter, is calculated by dividing the P-wave duration (PWD) by the PR interval. This study aimed to investigate the relation between PWDI and silent AF development in cardiac resynchronisation therapy defibrillator (CRT-D)-applied patients.
The study population consisted of 181 CRT-D device-implanted patients. Atrial fibrillation attacks that last at least 30 s with no symptoms were accepted as silent AF.
Patients were separated into two groups: "with silent AF" and "without silent AF". The without silent AF group comprised 121 patients (mean age: 62.9 ±8.7 years, 62% male). The with silent AF group included 60 patients (mean age: 67.9 ±9.7 years, 60% male). The silent AF group had significantly higher mean age ( = 0.001). PR duration was significantly higher in the without silent AF group ( = 0.001). Patients with first-degree IAB and PWDI values were significantly higher in the with silent AF group (-values were 0.001 and < 0.001, respectively). Age (OR = 1.073, 95% CI: 1.028-1.119, = 0.001) and PWDI (OR = 1.053, 95% CI: 1.028-1.078, < 0.001) were detected as independent predictors for silent AF in the binomial logistic regression analysis. In the ROC analysis, a PWDI cut-off value of 0.67 determined silent AF with 81.7% sensitivity and 51.4% specificity (AUC = 0.701, < 0.001).
P-wave duration index was significantly associated with silent AF in patients with CRT-D.
在植入起搏器的患者群体中，房颤（AF）发作可能是无症状的、有症状的，或者伴有并发症出现。P波时限指数（PWDI）是一个新参数，通过将P波时限（PWD）除以PR间期来计算。本研究旨在探讨PWDI与接受心脏再同步治疗除颤器（CRT-D）的患者无症状房颤发生之间的关系。
研究人群包括181例植入CRT-D设备的患者。持续至少30秒且无症状的房颤发作被视为无症状房颤。
患者被分为两组：“有无症状房颤”组和“无无症状房颤”组。无无症状房颤组包括121例患者（平均年龄：62.9±8.7岁，62%为男性）。有无症状房颤组包括60例患者（平均年龄：67.9±9.7岁，60%为男性）。无症状房颤组的平均年龄显著更高（P=0.001）。无无症状房颤组的PR间期显著更长（P=0.001）。一度房室传导阻滞和PWDI值在有无症状房颤组患者中显著更高（P值分别为0.001和<0.001）。在二项逻辑回归分析中，年龄（OR=1.073，95%CI：1.028-1.119，P=0.001）和PWDI（OR=1.053，95%CI：1.028-1.078，P<0.001）被检测为无症状房颤的独立预测因素。在ROC分析中，PWDI临界值为0.67时，诊断无症状房颤的敏感性为81.7%，特异性为51.4%（AUC=0.701，P<0.001）。
P波时限指数与接受CRT-D治疗的患者无症状房颤显著相关。
