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Updated: Jan 8, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

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Association of P-Wave Parameters With Left Atrial Hemodynamics in Atrial Cardiomyopathy

Melissa Kazantzi1, Aljoscha Mohr1, Ruth Schneider2

  • 1Department of Cardiology and Rhythmology, University Hospital St. Josef Hospital, Bochum, Germany.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|December 19, 2025
PubMed

Insights

Advanced interatrial block (IAB) on ECG reliably detects left atrial dysfunction in left atrial cardiomyopathy (AtCM). Other P-wave measures were less effective, highlighting IAB

Area of Science:

  • Cardiology
  • Electrophysiology
  • Biomedical Engineering

Background:

  • P-wave parameters from ECGs link to atrial fibrillation and stroke.
  • Left atrial cardiomyopathy (AtCM) involves fibrosis and dysfunction, driving AF and stroke.
  • This study investigates P-wave parameters for diagnosing AtCM and its hemodynamic impact.

Purpose of the Study:

  • To assess the relationship between P-wave characteristics and left atrial hemodynamics.
  • To evaluate the diagnostic utility of P-wave parameters in identifying AtCM.
  • To determine which P-wave parameters are most effective in detecting left atrial dysfunction.

Main Methods:

  • Prospective, monocentric study of hospitalized patients in sinus rhythm (age ≥18).
  • P-wave parameters analyzed alongside echocardiographic left atrial function measures.
  • Statistical comparison between patients with and without pathological P-wave findings.

Main Results:

  • 55% of 416 patients had ≥3 pathological P-wave abnormalities.
  • Advanced interatrial block (IAB) strongly correlated with impaired left atrial hemodynamics.
  • Patients with advanced IAB showed significant alterations in atrial size, function, and NT-proBNP.

Conclusions:

  • Advanced IAB is the most reliable P-wave indicator for left atrial dysfunction in AtCM.
  • Other P-wave indices, like PTFV1, were less informative for AtCM diagnosis.
  • Advanced IAB offers diagnostic value for AtCM, especially in stroke of undetermined source patients.
Abstract

Keywords:
P‐wave parametersadvanced interatrial blockatrial cardiomyopathy

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