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Analysis of P wave and P dispersion in children with secundum atrial septal defect

T F Ho1, E L Chia, W C Yip

  • 1Department of Physiology, Faculty of Medicine, National University of Singapore, 2 Medical Drive, Singapore 117597, Republic of Singapore. phshotf@nus.edu.sg

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|November 1, 2001
PubMed

Insights

Children with atrial septal defect (ASD) show prolonged P wave duration and dispersion, indicating potential conduction issues. These findings correlate with larger ASD size and atrial dilation, suggesting risks for arrhythmias.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Congenital Heart Disease

Background:

  • P maximum and P dispersion are established predictors of atrial fibrillation in adults.
  • Investigating these electrophysiological parameters in pediatric secundum atrial septal defect (ASD) is crucial for understanding associated risks.

Purpose of the Study:

  • To evaluate P maximum and P dispersion in children with secundum ASD compared to controls.
  • To assess the relationship between these electrophysiological measures, ASD size, and atrial dilation.

Main Methods:

  • Ninety-four children with ASD and 65 controls underwent 12-lead ECG to measure P wave duration, P maximum, and P dispersion.
  • Children were subgrouped by ASD size (small, moderate, large), and atrial dilation was assessed via echocardiography.

Main Results:

  • Children with ASD exhibited significantly longer P dispersion than controls (30.2 vs 26.4 ms).
  • Both P maximum and P dispersion increased significantly with larger ASD size (P < 0.001).
  • Right atrial dilation was associated with significantly longer P maximum (102.3 vs 82.8 ms) and greater P dispersion (36.1 vs 27.6 ms).

Conclusions:

  • Prolonged atrial conduction time and inhomogeneity are likely present in children with moderate to large ASD.
  • Atrial dilation in pediatric ASD patients is associated with prolonged atrial conduction parameters.
  • These findings highlight potential electrophysiological abnormalities in pediatric ASD that may predispose to arrhythmias.
Abstract

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