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Altered interatrial conduction detected in MADIT II patients bound to develop atrial fibrillation.

Holmqvist, Fredrik LU ; Platonov, Pyotr LU ; Carlson, Jonas LU ; Zareba, Wojciech and Moss, Arthur J (2009) In Annals of Noninvasive Electrocardiology 14(3). p.268-275
Abstract
BACKGROUND: Changes in P-wave morphology have recently been shown to be associated with interatrial conduction route used, without noticeable changes of P-wave duration. This study aimed at exploring the association between P-wave morphology and future atrial fibrillation (AF) development in the Multicenter Automatic Defibrillator Trial II (MADIT II) population. METHODS: Patients included in MADIT-II without a history of AF with sinus rhythm at baseline who developed AF during the study ("Pre-AF") were compared to matched controls without AF development ("No-AF"). Patients were followed for a mean of 20 months. A 10-minute high-resolution bipolar ECG recording was obtained at baseline. Signal-averaged P waves were analyzed to determine... (More)
BACKGROUND: Changes in P-wave morphology have recently been shown to be associated with interatrial conduction route used, without noticeable changes of P-wave duration. This study aimed at exploring the association between P-wave morphology and future atrial fibrillation (AF) development in the Multicenter Automatic Defibrillator Trial II (MADIT II) population. METHODS: Patients included in MADIT-II without a history of AF with sinus rhythm at baseline who developed AF during the study ("Pre-AF") were compared to matched controls without AF development ("No-AF"). Patients were followed for a mean of 20 months. A 10-minute high-resolution bipolar ECG recording was obtained at baseline. Signal-averaged P waves were analyzed to determine orthogonal P-wave morphology, P-wave duration, and RMS20. The P-wave morphology was subsequently classified into one of three predefined types using an automated algorithm. RESULTS: Thirty patients (age 68 +/- 7 years) who developed AF during MADIT-II were compared with 60 patients (age 68 +/- 8 years) who did not. P-wave duration and RMS20 in the Pre-AF group was not significantly different from the No-AF group (143 +/- 21 vs 139 +/- 30 ms, P=0.26, and 2.0 +/- 1.3 vs 2.1 +/- 1.0 muV, P=0.90). The distribution of P-wave morphologies was shifted away from Type 1 in the Pre-AF group when compared to the No-AF group (Type 1/2/3/atypical; 25/60/0/15% vs 10/63/10/17%, P=0.04). CONCLUSIONS: This study is the first to describe changes in P-wave morphology in patients prior to AF development. The results indicate that abnormal interatrial conduction may play a role in AF development in patients with prior myocardial infarction and congestive heart failure. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Noninvasive Electrocardiology
volume
14
issue
3
pages
268 - 275
publisher
Wiley-Blackwell
external identifiers
  • wos:000267871200008
  • pmid:19614639
  • scopus:62549110096
ISSN
1082-720X
DOI
10.1111/j.1542-474X.2009.00309.x
language
English
LU publication?
yes
id
595e81ec-6a9f-4f31-ad67-7d03834153ca (old id 1452991)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19614639?dopt=Abstract
date added to LUP
2009-08-04 12:52:56
date last changed
2017-01-22 04:17:09
@article{595e81ec-6a9f-4f31-ad67-7d03834153ca,
  abstract     = {BACKGROUND: Changes in P-wave morphology have recently been shown to be associated with interatrial conduction route used, without noticeable changes of P-wave duration. This study aimed at exploring the association between P-wave morphology and future atrial fibrillation (AF) development in the Multicenter Automatic Defibrillator Trial II (MADIT II) population. METHODS: Patients included in MADIT-II without a history of AF with sinus rhythm at baseline who developed AF during the study ("Pre-AF") were compared to matched controls without AF development ("No-AF"). Patients were followed for a mean of 20 months. A 10-minute high-resolution bipolar ECG recording was obtained at baseline. Signal-averaged P waves were analyzed to determine orthogonal P-wave morphology, P-wave duration, and RMS20. The P-wave morphology was subsequently classified into one of three predefined types using an automated algorithm. RESULTS: Thirty patients (age 68 +/- 7 years) who developed AF during MADIT-II were compared with 60 patients (age 68 +/- 8 years) who did not. P-wave duration and RMS20 in the Pre-AF group was not significantly different from the No-AF group (143 +/- 21 vs 139 +/- 30 ms, P=0.26, and 2.0 +/- 1.3 vs 2.1 +/- 1.0 muV, P=0.90). The distribution of P-wave morphologies was shifted away from Type 1 in the Pre-AF group when compared to the No-AF group (Type 1/2/3/atypical; 25/60/0/15% vs 10/63/10/17%, P=0.04). CONCLUSIONS: This study is the first to describe changes in P-wave morphology in patients prior to AF development. The results indicate that abnormal interatrial conduction may play a role in AF development in patients with prior myocardial infarction and congestive heart failure.},
  author       = {Holmqvist, Fredrik and Platonov, Pyotr and Carlson, Jonas and Zareba, Wojciech and Moss, Arthur J},
  issn         = {1082-720X},
  language     = {eng},
  number       = {3},
  pages        = {268--275},
  publisher    = {Wiley-Blackwell},
  series       = {Annals of Noninvasive Electrocardiology},
  title        = {Altered interatrial conduction detected in MADIT II patients bound to develop atrial fibrillation.},
  url          = {http://dx.doi.org/10.1111/j.1542-474X.2009.00309.x},
  volume       = {14},
  year         = {2009},
}