Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-23T22:40:52.892Z Has data issue: false hasContentIssue false

Assessment of P-wave dispersion in children with atrial septal aneurysm

Published online by Cambridge University Press:  25 September 2013

Derya Arslan*
Affiliation:
Department of Pediatric Cardiology, Medical Faculty, Selcuk University, Konya, Turkey
Derya Cimen
Affiliation:
Department of Pediatric Cardiology, Medical Faculty, Selcuk University, Konya, Turkey
Osman Guvenc
Affiliation:
Department of Pediatric Cardiology, Medical Faculty, Selcuk University, Konya, Turkey
Bulent Oran
Affiliation:
Department of Pediatric Cardiology, Medical Faculty, Selcuk University, Konya, Turkey
Fatma Hilal Yilmaz
Affiliation:
Department of Pediatrics, Medical Faculty, Selcuk University, Konya, Turkey
*
Correspondence to: Dr D. Arslan, Department of Pediatric Cardiology, Medical Faculty, Selcuk University, 42075 Konya, Turkey. Tel: 00. 90. 332. 2415000; Fax: 00. 90. 332. 323 6723; E-mail: [email protected]

Abstract

Background

This was a prospective controlled study to determine the P-wave duration and P-wave dispersion in patients with atrial septal aneurysm.

Methods

A total of 41 children with atrial septal aneurysm, including 21 boys and 20 girls (mean age 11.85 ± 3.8 years), and 32 controls, including 17 boys and 15 girls (mean age 12.3 ± 2.9 years), were included. P-wave dispersion was calculated from the 12-lead electrocardiogram. Cardiac functions, morphology of the aneurysm, and left atrial diameter were measured using conventional echocardiography. The diagnosis of atrial septal aneurysm was made when the base of the aneurysms with an excursion ratio ≥25% was found on echocardiography.

Results

There was no significant difference between the patient and control groups in demographic, clinical findings, and M-mode echocardiographic parameters. The P-wave dispersion in patients with atrial septal aneurysm was significantly longer compared with the control group (64.4 ± 13.4 ms; p < 0.0001). Similarly, the the maximum duration of the P wave in the patient group was significantly longer compared with the control group (106.1 ± 13.3 ms; p < 0.001). The P-wave duration and dispersion were not correlated with age, gender, systolic and diastolic blood pressure, or m-mode echocardiographic parameters.

Conclusions

This study shows that P-wave dispersion is delayed in atrial septal aneurysm patients. Prolonged P-wave dispersion was determined to indicate electrical disturbance, and therefore it has an increased electrocardiographic risk of atrial arrhythmia in children with atrial septal aneurysm.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Janion, M, Kurzawski, J, Sielski, J, Ciuraszkiewicz, K, Sadowski, M, Radomska, E. Dispersion of P wave duration and P wave vector in patients with atrial septal aneurysm. Europace 2007; 9: 471474.CrossRefGoogle ScholarPubMed
2. Giannopoulos, A, Gavras, C, Sarioglou, S, Agathagelou, F, Kassapoglou, I, Athanassiadou, F. Atrial septal aneurysms in childhood: prevalence, classification, and concurrent abnormalities. Cardiol Young 2013; 7: 16.Google Scholar
3. Agmon, Y, Khandheria, BK, Meissner, I, et al. Frequency of atrial septal aneurysms in patients with cerebral ischemic events. Circulation 1999; 99: 19421944.Google Scholar
4. Michelucci, A, Bagliani, G, Colella, A, et al. P wave assessment: state of the art update. Card Electrophysiol 2002; 3: 215220.Google Scholar
5. Lang, RM, Bierig, M, Devereux, RB, et al. Recommendations for chamber quantification. Eur J Echocardiogr 2006; 7: 79108.Google Scholar
6. Ozcelik, N, Atalay, S, Tutar, E, Ekici, F. Prevalence of interatrial septal aneurysm in newborns and their natural course. Pediatr Cardiol 2006; 27: 343346.Google Scholar
7. Alici, G, Ozkan, B, Yazicioglu, MV, et al. P-wave dispersion by 12-lead electrocardiography in carotid artery stenting. Clin Auton Res 2013; 23: 8184.Google Scholar
8. Guray, U, Guray, Y, Mercit, B, Yilmaz, MB, Sasmaz, H, Korkmaz, S. Maximum P wave duration and P wave dispersion in adult patients with secundum atrial septal defect: the impact of surgical repair. Ann Noninvasive Electrocardiol 2004; 9: 136141.Google Scholar
9. Nussinovitch, U. Meta-analysis of p-wave dispersion values in healthy individuals: the influence of clinical characteristics. Ann Noninvasive Electrocardiol 2012; 17: 2835.Google Scholar
10. Deveci, OS, Aytemir, K, Okutucu, S, et al. Evaluation of the relationship between atrial septal aneurysm and cardiac arrhythmias via p-wave dispersion and signal-averaged p-wave duration. Ann Noninvasive Electrocardiol 2010; 15: 157164.Google Scholar
11. Dilaveris, PE, Gialafos, EJ, Sideris, SK, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998; 135: 733738.Google Scholar
12. Dilaveris, PE, Gialafos, JE. P-wave duration and dispersion analysis: methodological considerations. Circulation 2001; 103: 111.Google Scholar
13. Janion, M, Kurzawski, J. Atrial fibrillation in patients with atrial septal aneurysm. Cardiol J 2007; 14: 580584.Google Scholar
14. Okutucu, S, Evranos, B, Aytemir, K, et al. Relationship between atrial septal aneurysms and atrial electromechanical delay. Int J Cardiovasc Imaging 2011; 27: 505513.Google Scholar
15. Janion, M, Kurzawski, J, Sielski, J, Ciuraszkiewicz, K, Sadowski, M, Radomska, E. Dispersion of P wave duration and P wave vector in patients with atrial septal aneurysm. Europace 2007; 9: 471474.Google Scholar
16. Guidera, SA, Steinberg, JS. The signal-averaged P wave duration: a rapid and noninvasive marker of risk of atrial fibrillation. J Am Coll Cardiol 1993; 21: 16451651.Google Scholar
17. Yamada, T, Fukunami, M, Shimonagata, T, et al. Prediction of paroxysmal atrial fibrillation in patients with congestive heart failure: a prospective study. J Am Coll Cardiol 2000; 35: 405413.CrossRefGoogle ScholarPubMed