Atrial conduction explains the occurrence of the P‐wave dispersion phenomenon, but weakly

• Published in: Journal of arrhythmia Vol. 36; no. 6; pp. 1083 - 1091
• Main Authors: Carmona Puerta, Raimundo, Chávez González, Elibet, Rabassa López‐Calleja, Magda Alina, Lorenzo Martínez, Elizabeth, Cruz Elizundia, Juan Miguel, Padrón Peña, Gustavo, Rodríguez González, Fernando
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.12.2020; John Wiley and Sons Inc; Wiley
• Subjects: Analysis; atrial conduction time; Cardiac arrhythmia; Catheters; Electrocardiography; electrophysiological study; maximum P‐wave duration; Medical research; Medicine, Experimental; Morphology; Original; Patients; P‐wave dispersion; Variables; atrial conduction time; P‐wave dispersion; electrophysiological study; maximum P‐wave duration
• ISSN: 1880-4276; 1883-2148
• DOI: 10.1002/joa3.12444

Background P‐wave dispersion (PWD) is believed to be caused by inhomogeneous atrial conduction. This statement, however, is based on limited little solid evidence. The aim of this study was to determine the relationship between atrial conduction and PWD by means of invasive electrophysiological studies. Methods Cross‐sectional study in 153 patients with accessory pathways and atrioventricular node reentry tachycardia (AVNRT) undergoing an electrophysiological study. Different atrial conduction times were measured and correlated with PWD. Results Only the interatrial (P‐DCS) and left intra‐atrial conduction times (ΔDCS‐PCS) showed a significant correlation with PWD, but this correlation was weak. Multivariate linear regression analysis determined that both P‐DCS (β = 0.242; P = .008) and ΔDCS‐PCS (β = 0.295; P < .001) are independent predictors of PWD. Performing the multivariate analysis for arrhythmic substrates, it is observed that only ΔDCS‐PCS continued to be an independent predictor of PWD. Analysis of the receiver operating characteristic curves showed that regardless of the types of arrhythmic substrates, PWD discriminates significantly, but moderately, to patients with P‐DCS and ΔDCS‐PCS ≥75 percentile. Conclusions Interatrial and intraleft atrial conduction times were directly and significantly correlated with PWD, but only weakly, and were independent predictors of PWD. In general, PWD correctly discriminates patients with high values in interatrial and intraleft atrial conduction times, but moderately. This is maintained in cases with accessory pathways; however, in patients with AVNRT it only does so for intraleft atrial conduction times. Interatrial and intraleft atrial conduction times weakly explains PWD. P‐wave dispersion (PWD) is considered by many to be an electrocardiographic parameter originating from regional differences in atrial conduction. The aim of this study was to determine the relationship between atrial conduction and PWD by means of invasive electrophysiological studies. Interatrial and intra left atrial conduction times were directly and significantly correlated with PWD, but weakly, and were independent predictors of PWD.