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Effect of diuresis on P-wave duration and dispersion
Jessica Song1, James S Kalus, Michael F Caron
1Drug Information Center, Hartford Hospital, Connecticut 06102-5037, USA.
Study Objective:
To evaluate the effects of changing volume status on P-wave duration and dispersion in patients with decompensated heart failure.
Design:
Prospective analysis.
Setting:
Hospital cardiology unit.
Patients:
Twenty-one patients with symptoms of decompensated heart failure who were treated with diuretics on admission.
Intervention:
Twelve-lead electrocardiograms were obtained at baseline and after diuresis. Average, minimum, and maximum P-wave duration and P-wave dispersion (minimum minus maximum duration) were determined.
Measurements And Main Results:
P-wave duration was measured manually in all 12 leads by using a 0.5-mm-scale precision ruler and magnifying lens. After 40+/-23 hours of diuresis, 3+/-1 L of fluid was removed. A significant correlation was found between average P-wave duration and amount of fluid removed (r = -0.59, p=0.015). Also, average and maximum P-wave duration were significantly decreased with diuresis (p=0.001 and 0.022, respectively). No other P-wave variables were significantly affected.
Conclusions:
Diuresis may attenuate electrophysiologic changes caused by fluid overload.