Electrocardiographic Markers For The Prediction Of Paraxysmal Atrial Fibrillation In Patients With Essential Hypertension

Objective To determine if patients with essential hypertension at risk of paroxysmal atrial fibrillation (PAP) can be identified while in sinus rhythm by measurements of P wave duration, P wave dispersion and variance of P wave duration. Methods We measured the maximum P wave duration(Pmax), the minimum P wave duration(Pmin), P wave dispersion (Pd) and variance of P wave duration(Pv) from the 12-Iead surface electrocardiogram of 50 essential hypertensive patients with history of PAF (group I , mean age 62) and 51 essential hypertensive patients without history of AF ( group II, mean age 59). Left atrial dimension (LAD) and left ventricular ejection fraction (LVEF) were measured by echocardiography. Results Pmax, Pd and Pv were found to be significantly higher in group I than group II (Pmax, 122. 50 ±11. 18 vs 105. 20 ± 8. 66ms, P< 0.001; Pd , 49.25 ± 14.26 vs 38.63 ± 10.59ms, P O.001; Pv, 244.30 ± 182. 08vsl67.15 ± 80. 54ms2, P< 0.001). LVEF was significantly lower in group I than group II (62. 03 ±6. 41vs65. 76 ± 5. 93, P< 0. 01). In univariate analysis, Pmax, Pd, Pv and LVEF were significant predictors of PAF, whereas only Pd and Pv remained significant independent predictors of PAF in the multivariate analysis. Conclusions Pmax, Pd and Pv are electrocardiographic markers that could be used for the prediction of essential hypertensive patients at risk of developing PAF. Pd and Pv remained significant independent predictors of PAF in the multivariate analysis.