Related Experiment Video
Updated: Aug 23, 2026
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
P wave dispersion and left atrial appendage function for predicting recurrence after conversion of atrial
Abdullah Dogan1, Halil Kahraman, Mustafa Ozturk
1Department of Cardiology, Medical School, Sevket Demirel Heart Center, Suleyman Demirel University, Isparta, Turkey. adogan35@hotmail.com
Insights
Increased P wave dispersion, larger left atrial size, and reduced left atrial appendage (LAA) function predict atrial fibrillation (AF) recurrence after cardioversion. These factors help identify patients at high risk for AF relapse.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Imaging
Background:
- Atrial fibrillation (AF) recurrence post-cardioversion remains a clinical challenge.
- Predictive markers for AF relapse are crucial for patient management.
- Understanding the interplay between P wave dispersion and left atrial appendage (LAA) function is important.
Purpose of the Study:
- To investigate P wave dispersion and LAA function as predictors of AF relapse.
- To explore the relationship between P wave dispersion and LAA function in AF patients.
- To identify key parameters for predicting AF recurrence after cardioversion.
Main Methods:
- Sixty-four patients with recent AF (
- P wave duration and dispersion measured via 12-lead ECG.
- Left atrium (LA) and LAA size and function evaluated using echocardiography.
Main Results:
- After 6 months, 28 patients (44%) experienced AF recurrence.
- Univariate predictors included AF duration, LA size, P wave duration/dispersion, spontaneous echo contrast, LAA area, and LAA emptying velocity.
- Multivariate analysis identified LA size, P wave dispersion, and LAA emptying flow as significant predictors of AF recurrence.
Conclusions:
- Elevated P wave dispersion, dilated LA, and impaired LAA emptying flow identify patients at risk for AF recurrence.
- These parameters offer valuable insights for predicting post-cardioversion AF relapse.
- The findings support the use of these measures in clinical risk stratification.
Background:
We investigated P wave dispersion and left atrial appendage (LAA) function for predicting atrial fibrillation (AF) relapse, and the relationship between P wave dispersion and LAA function.
Methods:
Sixty-four consecutive patients with AF lasting
Results:
After 6 months, 28 patients experienced recurrent AF and 36 remained in sinus rhythm. There was no difference between patients with and without recurrence in gender, age, underlying heart disease, AF patterns, left ventricular function, and maximum LAA area. AF duration >/=5 days, LA size >/=45 mm, maximum P wave duration >/=112 ms, P wave dispersion >/=47 ms, spontaneous echo contrast, minimum LAA area >/=166 mm(2), and LAA emptying velocity <36 cm/sec were univariate predictors of recurrence (each P < 0.05). By multivariate analysis, LA size (P = 0.02), P wave dispersion (P < 0.001), and LAA emptying flow (P = 0.01) identified patients with recurrent AF. Their positive predictive values were 91, 97, and 72%, respectively.
Conclusion:
The increased P wave dispersion in addition to the dilated LA and the depressed LAA emptying flow can identify patients at risk of recurrent AF after cardioversion.
Related Concept Videos
01:25Correlation between ECG and Cardiac Cycle
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias