Duration of P-wave is associated with atrial fibrillation hospitalizations in patients with atrial fibrillation and paced for bradycardia

Luigi Padeletti, Massimo Santini, Giuseppe Boriani, Gianluca Botto, Renato Ricci, Andrea Spampinato, Giuseppe Vergara, Werner G. Rahue, Alessandro Capucci, Michele Gulizia, Paolo Pieragnoli, Andrea Grammatico, Pyotr Platonov, S. Serge Barold

Research output: Contribution to journalArticle

Abstract

Background: Atrial fibrillation (AF) is a common problem in pacemaker patients. We conducted a prospective observational study in patients paced for bradycardia with associated paroxysmal or persistent AF, to determine whether P-wave duration may stratify patients at higher risk for AF recurrences and AF-related hospitalizations. The patients were evaluated for the prevalence, cause, and predictors of hospitalization. Methods: We studied 660 consecutive patients (50% male, 72 ± 9 years) who received a dual-chamber pacemaker. Median value of baseline P-wave duration was equal to 100 ms (25%-75% quartile range equal to 80-120 ms). We used this cut-off to divide the patients into group A (P ≤ 100 ms), composed of 385 (58.3%) patients, and group B (P>100 ms), composed of 275 (41.7%) patients. Results: In a median follow-up of 19 months, 173 patients were hospitalized for all causes, 130 for cardiovascular causes, and 85 for AF-related hospitalizations. Multivariate logistic analysis showed that P-wave duration >100 ms identified patients at higher risk (OR = 1.6, 95% confidence interval (1.1-2.8), P = 0.044) for AF-related hospitalizations. Patients in group B (P > 100 ms) more frequently suffered AF-related hospitalizations (16.4% vs 10.4%, P = 0.02) and underwent more frequent cardioversions (14.5% vs 9.1%, P = 0.029) compared with group A (P ≤ 100 ms). Conclusions: P-wave duration may define the risk of persistent AF requiring cardioversion or AF-related hospitalization in patients with a pacemaker for bradycardia with associated paroxysmal or persistent AF.

Original languageEnglish
Pages (from-to)961-969
Number of pages9
JournalPACE - Pacing and Clinical Electrophysiology
Volume30
Issue number8
DOIs
Publication statusPublished - Aug 2007

Keywords

  • Atrial fibrillation
  • Atrial tachyarrhythmia
  • Cardioversion
  • Electrocardiogram
  • P-wave
  • Pacing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Padeletti, L., Santini, M., Boriani, G., Botto, G., Ricci, R., Spampinato, A., Vergara, G., Rahue, W. G., Capucci, A., Gulizia, M., Pieragnoli, P., Grammatico, A., Platonov, P., & Barold, S. S. (2007). Duration of P-wave is associated with atrial fibrillation hospitalizations in patients with atrial fibrillation and paced for bradycardia. PACE - Pacing and Clinical Electrophysiology, 30(8), 961-969. https://doi.org/10.1111/j.1540-8159.2007.00793.x