Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2020, vol. 29, nr 11, November, p. 1347–1354

doi: 10.17219/acem/127680

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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P wave duration in paroxysmal and persistent atrial fibrillation

Malte Unkell1,A,B,C,D,E,F, Maxim Marinov1,A,B,C,D,E,F, Peter Stephan Wolff1,A,B,C,D,E,F, Jadwiga Radziejewska2,B,F, Jakub Szymon Mercik3,A,B,C,D,E,F, Jacek Gajek4,A,B,C,D,E,F

1 Students’ Scientific Association, Department of Emergency Medical Service, Wroclaw Medical University, Poland

2 Klodzko County Hospital, Poland

3 Department of Emergency Medicine, Wroclaw Medical University, Poland

4 Department of Emergency Medical Service, Wroclaw Medical University, Poland

Abstract

Background. Functional and structural changes in the atrial muscle constitute a substrate for atrial fibrillation (AF). The pathological changes in the left atrium decrease the conduction velocity and result in prolongation of the P wave duration.
Objectives. To assess the duration of the P wave in patients with AF in different clinical presentations of arrhythmia.
Material and Methods. The study group consisted of 119 patients diagnosed with AF: 57 women and 62 men, aged 65.3 ±9.4 years. There were 65 patients with paroxysmal AF and 54 with persistent AF. In this group, electrical cardioversion was performed. The P wave duration was measured using an electrophysiological system in all leads at a paper speed of 200 mm/s.
Results. The patients did not differ in terms of age, gender or comorbidities. The patients with persistent AF had longer P wave duration (159.9 ±22.3 ms compared to 144.6 ±17.2 ms; p < 0.001) and higher glucose concentration (119.4 ±33.4 mg/dL compared to 108.0 ±24.6 mg/dL; p = 0.015). These results were not influenced by the anti-arrhythmic treatment.
Conclusion. Persistent AF shows a longer P wave duration than the paroxysmal AF, independent of age, gender and anti-arrhythmic medication. The prolongation of the P wave related to persistent arrhythmia should force physicians to restore the sinus rhythm earlier in order to more successfully maintain it in the long term.

Key words

P wave duration, atrial fibrillation, diabetes mellitus, chronic kidney disease

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