Predictive Value Of P Wave Dispersion And High Sensitive C-reactive Protein In Patients With Paroxysmal Atrial Fibrillation And Its Effect Of Amiodarone

Objective:To investigate the predictive value of P wave dispersion(Pd) and plasma level of high sensitive C-reactive protein(hs-CRP) in patients with paroxysmal atrial fibrillation (PAF) and its effect of AmiodaroneMethods:From October 2007 to September 2009 in our hospital, 60 consecutive patients who were diagnosed PAF were regarded as study group by ECG or 24h-Holter; 60 cases people of health examination were regarded as control group. Control group and observation group (before and after amiodarone medication after 2 months) were measured Pd and hs-CRP. Then, firstly according to the level of hs-CRP before their treatments, all patients with PAF were divided into 2 groups: groupⅠ: hs-CRP<3.0mg/L n=2, groupⅡ: hs-CRP≥3.0mg/L n=58; while they also were divided into 2 groups according to their Pd of pre-therapy:groupⅢ:Pd<40ms n=4; groupⅣ: pd≥40ms n=56, who were followed up for 3 months. Subsequently, all patients with PAF were divided into 2 groups according to their hs-CRP levels of post-treatment: groupⅤ:hs-CRP<3.0mg/L n=44;groupⅥ:hs-CRP≥3.0mg/L n=16,while they also were divided into 2 groups according to their Pd of post-treatment:groupⅦ: Pd<40ms n=52; groupⅧ: pd≥40ms n=8, Out after 1 month of amiodarone, followed up for 3 months in patients with paroxysmal atrial fibrillation. Then, all PAF patients in each group,before and after taking the medication, are based on the onset of symptoms before treatment of atrial fibrillation,normal ECG or 24-hour Holter of atrial fibrillation observed changes,to understand the recurrence of PAF.Results : Compared with control group: Pd ( 28.1±7.0 ms ),hs-CRP(1.71±0.98mg/L),their change of P wave dispersion and hs-CRP of pre-therapy observation group: Pd(43.8±4.9ms),hs-CRP( 6.56±2.47 mg/L)were statistically significant difference(p<0.001),but there was no significant difference between post-treatment group: Pd(28.2±8.4ms),hs-CRP( 1.59±1.23 mg/L)and control group(P> 0.5). Recurrence of atrial fibrillation in groupⅠ was 0%, groupⅡrecurrence rate was 77.6%, the difference was significant (P<0.025); while groupⅢatrial fibrillation recurrence rate 25%, groupⅣ, recurrence rate 89.3% difference was also statistically significant (P<0.005). the PAF recurrence rate of groupⅤwas lower significantly than groupⅥ(6.82%vs37.5%,p<0.005);while there was significant difference between groupⅦand groupⅧ(7.7%vs50% p<0.005). But before and after of the medication , the recurrence rate of atrial fibrillation was no significant difference (P> 0.5) in the hs-CRP<3.0mg/L groups, and hs-CRP≥3.0mg/L groups was significantly (P <0.005 ); while the recurrence rate of atrial fibrillation was no significant difference (P> 0.1) in Pd<40ms groups, and Pd≥40ms groups significantly was statistically significant (P <0.001).Conclusion:Both Pd and plasma hs-CRP are good predictors to PAF recurrence, Amiodarone can significantly reduce the recurrence of PAF.