A Study On The Predictive Value Of P Wave Width And Dispersion And The Maximum Left Atrial Diameter In Patients With New Atrial Fibrillation After Acute Myocardial Infarction

Objective The maximum P wave width(P_max),minimum P wave width(P_min),P wave dispersion（PD）and maximum left atrial diameter（MLAD）were measured in patients with acute myocardial infarction and atrial fibrillation,to investigate the relationship between maximal P wave width(P_max),P wave dispersion（PD）,maximum left atrial diameter（MLAD）and atrial fibrillation after acute myocardial infarction.Method A total of 50 patients with atrial fibrillation and acute myocardial infarction（Ami）were enrolled in our hospital from January 2018 to December 2019,and 50 patients without af were enrolled.All participating researchers were exTIMIned and analyzed by 12-lead body surface electrocardiogram,MLAD,Pmax and Pd were observed,and new atrial fibrillation was predicted and analyzed for patients in atrial fibrillation group.Results There was no significant difference in Pmin between atrial fibrillation group and non-atrial fibrillation group（p>0.05）,and there was no statistical significance.there was significant difference in left atrial maximum diameter,Pmax and pd（p<0.05）.when the patient was diagnosed with left atrial diameter≥60mm,Pmax≥110ms and Pd≥40ms,the sensitivity was5.6%,83.2%and 81.1%,and the specificity was 82.6%76.3%and 86.4%.Positive predictive values were 85.6%,80.5%and 85.0%.Logistic regression analysis showed that age,hypertension,myocardial infarction,left atrial maximum diameter,P wave dispersion and TIMI risk score were significantly correlated with patients’new onset atrial fibrillation.In addition,ROC curve was used to predict the incidence of atrial fibrillation,mainly starting from the analysis of four factors such as left atrial maximum diameter,Pmax and Pd,and TIMI score.After examination and analysis,it is found that the upper area and lower area of the largest inner diameter of the left atrium are 1.098 and 0.036 respectively,which are lower than the MIMI score curve of 0.743（P=0.022）.The combined prediction of the two factors in the larger inner diameter,Pmax and Pd of the left atrium has a P value of less than 0.05.According to Youden index,Pd and TIMI risk factors were selected,and the cut-off points were set at 40ms,≥20mm and≤60mm,and<5 points.The final prediction sensitivity was 73.3%,76.0%and 75.6,the specificity was 82.5%,84.6%and 85.4%,respectively,and the positive prediction values were89.6%,89.9%and 96.5%Conclusion P-wave width,P-wave dispersion and the maximum left atrial diameter can predict the occurrence of AF,which can provide a reference for the early detection and prevention of AF.The combination of P dispersion,maximum left atrial diameter and TIMI risk score can predict the occurrence of AF with higher accuracy.