Background

P wave dispersion (PWD) consistitute a recent contribution to the field of non invasive electrocardiography. It is an electrocardiography measurement, which reflect a disparity in atrial conduction. Atrial fibrillation (AF) is the most important risk factor for stroke; it has a deleterious effect on longevity with doubling of all cause mortality. The estimation of the probability of recurrent AF by using a simple parameter might guide the clinician in the management of these patients.

Objective

To asses the value of PWD as a predictor of AF recurrence in patient with successful cardioversion to sinus rhythm.

patient and methods: Sixty two patients who had recent onset AF and successfully converted to sinus rhythm were included. They were followed up for recurrence of AF for six months. All patients were subjected to the following: through history, clinical examination, standard 12 lead ECG for PWD calculation, Echo-doppler to measure LA diameter, left ventricular systolic and diastolic function.

Results

According to af recurrence, the patients were classified into: Group 1 included 36 patients with recurred AF and Group !1 included 26 patients with persevered sinus rhythm (PSR). Maximum p wave duration was significantly longer in group 1 than in group 11(p < 0.04). PWD was significantly higher in group 1(71 ± 21 ms) than those in group 11(40 ± 15 ms)(p < 0.000) with sensitivity of 75% and specify of 88.5% at cutoff point >80.5 ms.Statistically significant left ventricular diastolic dysfunction (in the form of impaired and pseudo normal relaxation) and increased left atrial diameter were mor obvious in group 1 than those in group 11(p < 0.000 and P, 0.007 respectively). Logistic regression analysis for p max, PWD, LAD and EF% revealed that PWD is independent predictor for recurrence (r = 0.585, p < 0.000).

Conclusion

PWD measured from the ECG may be considered one of the predictor for AF recurrence.