Related Experiment Video

Updated: Aug 26, 2026

Programmed Electrical Stimulation in Mice
07:29

Programmed Electrical Stimulation in Mice

Published on: May 26, 2010

The role of P wave duration as a predictor of postoperative atrial arrhythmias

A E Buxton, M E Josephson

    Chest
    |July 1, 1981
    PubMed

    Insights

    Intra-atrial conduction defects (IACD) detected by total P wave duration (TPWD) predict atrial fibrillation (AF) and flutter (AFI) after bypass surgery. A prolonged isoelectric interval (IEI) further enhances prediction accuracy for these common arrhythmias.

    Area of Science:

    • Cardiology
    • Cardiac Electrophysiology
    • Postoperative Arrhythmias

    Background:

    • Atrial fibrillation (AF) and flutter (AFI) are frequent complications following aortocoronary bypass grafting.
    • Identifying patients at high risk for these arrhythmias is crucial for effective management.

    Purpose of the Study:

    • To evaluate the predictive value of intra-atrial conduction defects (IACD) for AF-AFI after bypass surgery.
    • To assess the utility of total P wave duration (TPWD) and isoelectric interval (IEI) in predicting these postoperative arrhythmias.

    Main Methods:

    • Ninety-nine patients undergoing bypass surgery were monitored using a three-channel ECG.
    • IACDs were identified using conventional P wave duration criteria and a novel TPWD measurement.
    • The isoelectric interval (IEI) was calculated by subtracting lead 2 P wave duration from TPWD.

    Main Results:

    • Sustained AF-AFI occurred in 29% of patients.
    • Patients with AF-AFI exhibited significantly longer mean TPWD (126 msec vs. 116 msec) and IEI (12.4 msec vs. 5.9 msec) compared to those without.
    • IACD-TPWD was a sensitive but non-specific predictor of AF-AFI, while a prolonged IEI enhanced specificity.

    Conclusions:

    • TPWD measurement, reflecting IACD, is a valuable tool for identifying patients at risk of AF-AFI post-bypass.
    • Combining TPWD with IEI analysis improves the specificity of predicting these common postoperative arrhythmias.

    More Related Videos

    Optimization of Transesophageal Atrial Pacing to Assess Atrial Fibrillation Susceptibility in Mice08:05

    Optimization of Transesophageal Atrial Pacing to Assess Atrial Fibrillation Susceptibility in Mice

    Published on: June 29, 2022

    Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding10:39

    Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding

    Published on: August 30, 2024

    Related Concept Videos

    Correlation between ECG and Cardiac Cycle01:25

    Correlation between ECG and Cardiac Cycle

    The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
    A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
    Dysrhythmias III: Characteristics of Dysrhythmias01:29

    Dysrhythmias III: Characteristics of Dysrhythmias

    Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per minute.
    Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

    Dysrhythmias IV: Characteristics of Bradyarrhythmias

    Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
    Dysrhythmias V: Evaluating Dysrhythmias01:30

    Dysrhythmias V: Evaluating Dysrhythmias

    Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
    Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

    Cardiomyopathy VII: Pre and Post Operative Nursing Management

    Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
    ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

    ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

    Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...