[Estimation of the P wave and PQ interval dispersion in patients with the recent myocardial infarction]

The supraventricular arrhythmia, and especially paroxysmal atrial fibrillation occurred in patients with the recent myocardial infarction are considered to be important therapeutical problem. The estimation of the P wave dispersion could be a method useful to differentiate the group of patients liable to suffer from this dysrhythmia. The aim of this paper was to estimate the P wave and PQ interval dispersion in patients with the recent myocardial infarction in dependence on the location, applied fibrinolytic treatment and the presence of the supraventricular arrhythmia.

The investigations were conducted on 46 patients (included 16 women) in age 41 to 84 years (mean 60+/-11.8 years), and among them there were 24 patients (8 women and 16 men) aged from 41 to 84 suffering from the inferior myocardial infarction and 22 patients (8 women and 14 men) aged from 44 to 81 with the anterior myocardial infarction. The estimation of the P wave and PQ interval dispersion was made by two independent researches on the 12-lead electrocardiogram, by using scanner and computer program Photo-Finish. There were analysed two electrocardiograms made in the first day, immediately after admitting of patient and 3 hours later, as well as the electrocardiograms made in the second, third, fourth and fifth day of disease. During the echocardiography the dimensions of the left atrium were estimated, and in the first and fifth day of hospitalization there was made 24-hours ECG monitoring by Holter method for the supraventricular arrhythmia diagnosing.

1. In patients with the recent myocardial infarction, irrespective of the location, applied fibrinolytic treatment or the supraventricular arrhythmia occurrence, the minimal and maximal lasting period of P wave and its dispersion were significantly higher comparing to control group. 2. The minimal and maximal lasting period of P wave and its dispersion were significantly lower in the following examinations comparing to the initial examination. 3. There were no significant differences in the maximal and minimal lasting period of P wave and its dispersion shown in patients suffering from the supraventricular arrhythmia comparing to the patients without the supraventricular arrhythmia. 4. It was no correlation between the left atrium dimensions and the maximal and minimal lasting period of P wave and its dispersion in the estimated groups. 5. The PQ interval dispersion and the minimal and maximal lasting period of PQ interval was not different only in the patients effectively treated by fibrinolysis comparing to the control group. 6. In all the patients in the fifth day of disease, the maximal and minimal lasting period PQ interval and its dispersion were significantly lower comparing to the electrocardiogram made after the admitting. 7. Till the fourth day (included) in patients suffering from the anterior myocardial infarction of the maximal and minimal lasting period of PQ interval was significantly longer than in patients with the inferior myocardial infarction, but there were no differences in PQ dispersion between them. 8. In patients with the myocardial infarction without the assisted supraventricular arrhythmia, the PQ interval dispersion measured in the electrocardiograms made three hours after the admitting and in these made in the following days was significantly lower comparing to the group of patients with supraventricular arrhythmia. 9. It was no correlation between the left atrium dimensions and the maximal and minimal lasting period of PQ interval and its dispersion.