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Prolonged P wave duration in adults with secundum atrial septal defect: a marker of delayed conduction rather than increased atrial size?

Thilén, Ulf LU ; Carlson, Jonas LU ; Platonov, Pyotr LU ; Havmöller, Rasmus LU and Olsson, Bertil LU (2007) In Europace 9(Suppl 6). p.105-108
Abstract
AIMS: Although atrial fibrillation is a frequent complication of an atrial septal defect (ASD) of the secundum type, the underlying mechanisms are poorly understood. Atrial conduction disturbances, manifested as a prolonged P-wave duration, have been suggested as a substrate for arrhythmia. Prolongation of the P-wave in unrepaired ASD has been demonstrated by means of the conventional ECG, but not by more sophisticated methods. The aim of the study was to analyse P-wave duration and morphology by high-resolution P-wave signal-averaged ECG (PSA-ECG) and to investigate potential atrial mechano-electrical interactions in adults with an unrepaired ASD. METHODS AND RESULTS: P-wave signal-averaged-ECG was obtained in 35 adult patients (age 53... (More)
AIMS: Although atrial fibrillation is a frequent complication of an atrial septal defect (ASD) of the secundum type, the underlying mechanisms are poorly understood. Atrial conduction disturbances, manifested as a prolonged P-wave duration, have been suggested as a substrate for arrhythmia. Prolongation of the P-wave in unrepaired ASD has been demonstrated by means of the conventional ECG, but not by more sophisticated methods. The aim of the study was to analyse P-wave duration and morphology by high-resolution P-wave signal-averaged ECG (PSA-ECG) and to investigate potential atrial mechano-electrical interactions in adults with an unrepaired ASD. METHODS AND RESULTS: P-wave signal-averaged-ECG was obtained in 35 adult patients (age 53 +/- 15 years) with ASD and compared with an equal number of sex- and age-matched healthy controls. Right and left atrial sizes were assessed by echocardiography in the ASD group. P wave duration was significantly longer in the ASD group than in control subjects (148 +/- 16 vs. 128 +/- 15 ms, P < 0.0001). P-wave morphology did not differ significantly between patients and controls. There was no clear relation between P-wave duration and atrial size. CONCLUSION: Atrial septal defect in the adult is characterized by a prolonged P-wave duration, indicating delayed atrial conduction, which is not related to the enlargement of the atria but rather to conduction delay. The nature and potential reversibility of this warrant further investigation. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Europace
volume
9
issue
Suppl 6
pages
105 - 108
publisher
Oxford University Press
external identifiers
  • pmid:17959685
  • wos:000251608700016
  • scopus:41249098384
ISSN
1532-2092
DOI
10.1093/europace/eum214
language
English
LU publication?
yes
id
38cfbacc-5009-45c7-8faf-cfaa1a0d965a (old id 1035758)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/17959685?dopt=Abstract
date added to LUP
2009-04-28 09:57:30
date last changed
2017-09-03 04:49:31
@article{38cfbacc-5009-45c7-8faf-cfaa1a0d965a,
  abstract     = {AIMS: Although atrial fibrillation is a frequent complication of an atrial septal defect (ASD) of the secundum type, the underlying mechanisms are poorly understood. Atrial conduction disturbances, manifested as a prolonged P-wave duration, have been suggested as a substrate for arrhythmia. Prolongation of the P-wave in unrepaired ASD has been demonstrated by means of the conventional ECG, but not by more sophisticated methods. The aim of the study was to analyse P-wave duration and morphology by high-resolution P-wave signal-averaged ECG (PSA-ECG) and to investigate potential atrial mechano-electrical interactions in adults with an unrepaired ASD. METHODS AND RESULTS: P-wave signal-averaged-ECG was obtained in 35 adult patients (age 53 +/- 15 years) with ASD and compared with an equal number of sex- and age-matched healthy controls. Right and left atrial sizes were assessed by echocardiography in the ASD group. P wave duration was significantly longer in the ASD group than in control subjects (148 +/- 16 vs. 128 +/- 15 ms, P &lt; 0.0001). P-wave morphology did not differ significantly between patients and controls. There was no clear relation between P-wave duration and atrial size. CONCLUSION: Atrial septal defect in the adult is characterized by a prolonged P-wave duration, indicating delayed atrial conduction, which is not related to the enlargement of the atria but rather to conduction delay. The nature and potential reversibility of this warrant further investigation.},
  author       = {Thilén, Ulf and Carlson, Jonas and Platonov, Pyotr and Havmöller, Rasmus and Olsson, Bertil},
  issn         = {1532-2092},
  language     = {eng},
  number       = {Suppl 6},
  pages        = {105--108},
  publisher    = {Oxford University Press},
  series       = {Europace},
  title        = {Prolonged P wave duration in adults with secundum atrial septal defect: a marker of delayed conduction rather than increased atrial size?},
  url          = {http://dx.doi.org/10.1093/europace/eum214},
  volume       = {9},
  year         = {2007},
}