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Evaluation of electrocardiographic P wave parameters in predicting long-term atrial fibrillation in patients with
Tufan Çinar1, Mert İlker Hayiroğlu2, Murat Selçuk1
1Health Sciences University, Sultan II, Abdülhamid Han Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
Insights
P wave duration (PWD) is the most effective electrocardiographic parameter for predicting long-term atrial fibrillation (AF) risk in patients with acute ischemic stroke. This finding aids in early detection and management of AF in stroke survivors.
Area of Science:
- Cardiology
- Neurology
- Medical Diagnostics
Background:
- Electrocardiographic (ECG) parameters, including P wave peak time (PWPT), P wave duration (PWD), and P wave amplitude, are used to evaluate left atrial abnormalities.
- These left atrial anomalies are associated with the development of atrial fibrillation (AF) in various patient cohorts.
- Assessing these ECG markers can help identify individuals at risk for AF.
Purpose of the Study:
- To compare the efficacy of different P wave electrocardiographic parameters in predicting long-term AF risk.
- Specifically focused on patients who have experienced acute ischemic stroke.
- To determine the most valuable P wave parameter for AF risk stratification in this population.
Main Methods:
- Retrospective analysis of data from 231 consecutive patients with acute ischemic stroke.
- ECG recordings were independently interpreted by two cardiologists to measure PWPT, PWD, and P wave amplitude in lead DI.
- Patients were followed for a median period of 16 months to detect AF development.
Main Results:
- Atrial fibrillation (AF) was detected in 18.6% of the study cohort.
- All evaluated P wave parameters showed statistical significance in cases with AF.
- Multivariable analysis identified PWD, PWPT, and advanced interatrial block morphology as independent predictors of long-term AF. P wave duration demonstrated the highest predictive accuracy (area under the curve, sensitivity, and specificity).
Conclusions:
- P wave duration (PWD) emerged as the most effective P wave parameter for predicting long-term AF in patients with acute ischemic stroke.
- This study highlights the utility of PWD in risk-stratifying stroke patients for AF.
- The findings suggest PWD can be a valuable tool for clinical decision-making in managing AF risk post-stroke.
Background:
Electrocardiographic parameters, such as P wave peak time (PWPT), P wave duration (PWD), and P wave amplitude in lead DI, have been utilized to assess left atrial anomalies linked to the development of atrial fibrillation (AF) in different cohort settings.
Objective:
To compare electrocardiographic parameters, such as P waves, in predicting long-term AF risk in acute ischemic stroke cases.
Methods:
The data of 231 consecutive acute ischemic stroke cases were retrospectively collected. Two independent cardiologists interpreted the electrocardiography recordings for PWPT, PWD, and P wave amplitude in lead DI. The median follow-up study period was 16 (interquartile range [IQR]: 11-24) months.
Results:
In total, AF was detected in 43 (18.6%) cases. All studied P wave parameters were found to be statistically significant in cases with AF. Based on multivariable logistic regression analysis, dementia, left atrium volume index, PWD (razão de chances [RC]: 1.11; 95% confidence interval [CI]: 1.058-1.184; p = 0.003), PWPT in lead DII (RC: 1.030; 95%CI: 1.010-1.050; p = 0.003), and advanced interatrial block morphology were independent predictors of long-term AF. P wave duration had the highest area under the curve value, sensitivity, and specificity for long-term AF in such cases compared with the other P wave parameters.
Conclusions:
Our head-to-head comparison of well-known P wave parameters demonstrated that PWD might be the most useful P wave parameter for long-term AF in acute ischemic stroke cases.
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