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Evaluation of Electrocardiographic P Wave Parameters in Predicting Long-term Atrial Fibrillation in Patients with Acute Ischemic Stroke

Overview
Publisher Thieme
Specialties Neurology
Psychiatry
Date 2022 Nov 9
PMID 36351415
Authors
Affiliations
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Abstract

Background: Electrocardiographic parameters, such as P wave peak time (PWPT), P wave duration (PWD), and P wave amplitude in lead DI, have been utilized to assess left atrial anomalies linked to the development of atrial fibrillation (AF) in different cohort settings.

Objective: To compare electrocardiographic parameters, such as P waves, in predicting long-term AF risk in acute ischemic stroke cases.

Methods: The data of 231 consecutive acute ischemic stroke cases were retrospectively collected. Two independent cardiologists interpreted the electrocardiography recordings for PWPT, PWD, and P wave amplitude in lead DI. The median follow-up study period was 16 (interquartile range [IQR]: 11-24) months.

Results: In total, AF was detected in 43 (18.6%) cases. All studied P wave parameters were found to be statistically significant in cases with AF. Based on multivariable logistic regression analysis, dementia, left atrium volume index, PWD (razão de chances [RC]: 1.11; 95% confidence interval [CI]: 1.058-1.184;  = 0.003), PWPT in lead DII (RC: 1.030; 95%CI: 1.010-1.050;  = 0.003), and advanced interatrial block morphology were independent predictors of long-term AF. P wave duration had the highest area under the curve value, sensitivity, and specificity for long-term AF in such cases compared with the other P wave parameters.

Conclusions: Our head-to-head comparison of well-known P wave parameters demonstrated that PWD might be the most useful P wave parameter for long-term AF in acute ischemic stroke cases.

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