Altered interatrial conduction detected in MADIT II patients bound to develop atrial fibrillation.
(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)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1452991
- author
- Holmqvist, Fredrik LU ; Platonov, Pyotr LU ; Carlson, Jonas LU ; Zareba, Wojciech and Moss, Arthur J
- organization
- publishing date
- 2009
- 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
- 2016-04-04 08:54:49
- date last changed
- 2022-01-29 07:39:35
@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}}, doi = {{10.1111/j.1542-474X.2009.00309.x}}, volume = {{14}}, year = {{2009}}, }