Analysis of P-wave changes after electrical cardioversion in patients with atrial fibrillation

Objective: T he study of characteristics of post-cardioversion P-waves and their relationship with atrial fibrillation recurrence.
Methods: In the prospective study 15 patients (10 male, 5 female, average age 62 years) with nonvalvular, persistent atrial fibrillation were included. In every case we determined the most important amplitude, durati-on and morphology parameters of post-cardioversion P-waves, right after electrical cardioversion and on the second day (before cardioversion). We did manual measurements on ECG registrations performed with paper speed of 50 mm/s and 20 mm/mV amplification. Chi-square test was used for statistical analysis (signi-ficance if p<0.05).
Results: Atrial fibrillation recurrence in the first month was present in the 33% of patients. We observed significant correlation (p<0.0001) between the increased duration (>0.12 s), the increased dispersion (>0.04 s) of post-cardioversion P-waves and the recurrence of atri-al fibrillation. In every case when the dispersion was <0.04 s, recurrence was not present.
Conclusions: Dispersion of P-waves measured immediately post-cardioversion is an important predictive factor of the atrial fibrillation recurrence. Early increase of dispersion reflects more exactly the heterogeneous atrial electric activity and the prolonged inter-atrial conduction time, important factors of atrial arrhyth-mogenicity.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)