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Relationship of V1 Derivation Biphasic P Waves with Morbidity and Mortality in Myocardial Infarction Cases

Burak Demirci1, Abuzer Coskun1, Cilem Bakar1

  • 1Department of Emergency Medicine, University of Health Sciences, Bagcilar Education & Research Hospital, Bagcilar, Istanbul, Turkey.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|August 6, 2022
PubMed

Insights

The biphasic P (V1bP) wave in lead V1 can predict three-vessel disease (TVD), bypass needs, and mortality in acute coronary syndrome patients. This ECG finding aids in assessing patient risk and guiding treatment decisions.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Electrocardiography

Background:

  • Acute coronary syndrome (ACS) management requires accurate risk stratification.
  • The biphasic P wave in lead V1 (V1bP) is an electrocardiographic finding with potential prognostic value.
  • Understanding V1bP wave characteristics may improve patient outcomes in ACS.

Purpose of the Study:

  • To evaluate the prognostic significance of the V1bP wave in lead V1.
  • To determine the association of V1bP wave patterns with three-vessel disease (TVD), need for bypass surgery, and mortality in ACS patients.

Main Methods:

  • A descriptive study involving 497 ACS patients admitted to an emergency department.
  • Patients were categorized based on the V1bP wave direction (right or left atrial involvement).
  • Comparison of Gensini score (GS), left ventricular ejection fraction (LVEF), TVD, bypass rates, and mortality between groups.

Main Results:

  • The left atrial group showed a higher incidence of anterior myocardial infarction, while the right atrial group had more inferior myocardial infarction.
  • Significant associations were found between V1bP wave patterns and mortality (p=0.019), bypass (p<0.001), and complications (p=0.043).
  • Mild to moderate correlations were observed between V1bP wave characteristics and ACS severity indicators like LVEF and GS.

Conclusions:

  • The V1bP wave in lead V1 serves as a valuable parameter for assessing TVD, bypass likelihood, and mortality risk in ACS.
  • This ECG marker can aid clinicians in risk stratification and management planning for ACS patients.
Abstract

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