Astan Ramazan, Kacmaz Fehmi, Saricam Ersin, Ilkay Erdogan
Batman Training and Research Hospital, Batman, Turkey.
Department of Cardiology, Faculty of Medicine, Uskudar University, İstanbul, Turkey.
Ann Noninvasive Electrocardiol. 2025 May;30(3):e70076. doi: 10.1111/anec.70076.
Atrial septal defect (ASD) can lead to volume overload and related changes in P-wave parameters in surface electrocardiograms of these patients. In this study, we aimed to evaluate the effect of volume overload on P-wave parameters in patients with ASD.
This study is a retrospective cohort analysis. A total of 142 patients with secundum ASD who underwent percutaneous closure were evaluated. P-wave duration (Pmax) and P-wave dispersion (PWD) were measured on the surface ECG before and 1 h after the closure procedure. We evaluated P-wave parameters in terms of defect size, duration of the volume overload, and closure device sizes.
Pmax and PWD were significantly decreased after the procedure compared with the values before the procedure (p < 0.001). Pmax values had a statistically significant correlation with ASD size (< 20 mm or ≥ 20 mm) both before and after the procedure. Pmax values were significantly higher in patients older than 30 years of age (119.6 ± 19.5 vs. 102.7 ± 17.1 ms, respectively; p = 0.039). A significantly positive correlation was found between pre- and post-procedural Pmax and defect sizes (r = 0.474, p = 0.019 and r = 0.4233, p = 0.04, respectively). However, no positive correlation between PWD and defect age and size was present.
Percutaneous closure of ASD is associated with an immediate decrease in both Pd and Pmax that seems to be related to the acute volume overload cessation in cardiac chambers.
房间隔缺损（ASD）可导致这些患者体表心电图中P波参数的容量负荷过重及相关变化。在本研究中，我们旨在评估容量负荷过重对ASD患者P波参数的影响。
本研究为回顾性队列分析。共评估了142例接受经皮封堵术的继发孔型ASD患者。在封堵术前及术后1小时测量体表心电图上的P波时限（Pmax）和P波离散度（PWD）。我们根据缺损大小、容量负荷过重持续时间和封堵装置大小评估P波参数。
与术前相比，术后Pmax和PWD显著降低（p < 0.001）。术前和术后Pmax值与ASD大小（< 20 mm或≥ 20 mm）均具有统计学显著相关性。30岁以上患者的Pmax值显著更高（分别为119.6 ± 19.5与102.7 ± 17.1 ms；p = 0.039）。术前和术后Pmax与缺损大小之间均发现显著正相关（分别为r = 0.474，p = 0.019和r = 0.4233，p = 0.04）。然而，PWD与缺损年龄和大小之间未发现正相关。
ASD的经皮封堵术与Pd和Pmax的即刻降低有关，这似乎与心腔急性容量负荷过重的停止有关。
