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P-wave dispersion in children with acute rheumatic fever

Celebi Kocaoglu1, Ahmet Sert, Ebru Aypar

  • 1Department of Pediatrics, Konya Training and Research Hospital, 42080, Konya, Turkey.

Pediatric Cardiology
|September 8, 2011
PubMed

Insights

P-wave dispersion, an electrocardiogram marker, is elevated in children with acute rheumatic fever. This finding suggests potential cardiac electrical abnormalities in pediatric rheumatic fever patients, especially those with carditis.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Rheumatology

Background:

  • P-wave dispersion (PWD) is a novel electrocardiographic (ECG) marker reflecting sinus impulse propagation heterogeneity.
  • Previous studies suggest PWD is linked to atrial electrical instability.

Purpose of the Study:

  • To evaluate P-wave dispersion in children diagnosed with acute rheumatic fever (ARF).
  • To compare PWD between ARF patients with and without carditis, and healthy controls.

Main Methods:

  • A case-control study involving 47 children with ARF (29 with carditis, 18 without) and 31 healthy controls.
  • Measurement of maximum and minimum P-wave durations from standard 12-lead ECGs.
  • Calculation of P-wave dispersion as the difference between maximum and minimum P-wave durations.

Main Results:

  • Children with ARF exhibited significantly higher maximum P-wave duration and P-wave dispersion compared to healthy controls.
  • ARF patients with carditis showed significantly greater P-wave dispersion than those without carditis.
  • Elevated P-wave dispersion was observed in both ARF subgroups versus controls.

Conclusions:

  • P-wave dispersion is significantly increased in children suffering from acute rheumatic fever.
  • PWD may serve as a valuable, non-invasive marker for detecting atrial electrical abnormalities in pediatric rheumatic fever.
  • The degree of PWD elevation correlates with the presence of carditis in acute rheumatic fever.

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