Usefulness of P-Wave Dispersion in Standard Twelve-Lead Electrocardiography to Predict Transition from Paroxysmal to Persistent Atrial Fibrillation
Abstract
A prospective study was conducted to investigate the validity of the hypothesis that P-wave dispersion (Pd) may be a clinically useful predictor of progression from paroxysmal to persistent atrial fibrillation (AF). Two hundred four consecutive patients with a diagnosis of paroxysmal AF were studied. Standard 12-lead electrocardiography and echocardiography were performed on all patients at the time of entry into the study. Pd was measured as the difference between maximum and minimum P-wave duration in any of the 12 leads. Mean follow-up was 66 +/- 8 months. Group I included patients (n = 132) in whom paroxysmal AF did not progress to persistent AF, and group II included those (n = 72) who developed persistent AF. In group II, age, percentage of men, percentage of patients with diabetes mellitus, maximum P-wave duration, Pd, and left atrial dimension were significantly higher than in group I (p <0.05). Multivariate logistic regression analysis using these 6 factors identified age (odds ratio 2.18, 95% confidence interval 1.41 to 3.41, p <0.01) and Pd (odds ratio 1.91, 95% confidence interval 1.51 to 2.44, p <0.01) as independent predictors of a transition to persistent AF. Pd >or=40 ms predicted progression to persistent AF with sensitivity of 71%, specificity of 77%, positive predictive value of 63%, negative predictive value of 83%, and accuracy of 75%. In conclusion, Pd was a clinically useful predictor of progression from paroxysmal to persistent AF.
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P-wave dispersion in standard twelve-lead ECG is a good predictor of transition from paroxysmal to persistent atrial fibrillation.
“P-wave dispersion in standard twelve-lead ECG was found to be a good predictor of transition from paroxysmal to persistent atrial fibrillation. 12”
From The Year of 2008 in Electrocardiology (2010) · cites this paper as [12]
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- Authors
- Koide, Y., Yotsukura, M., Ando, H., Aoki, S., Suzuki, T., Sakata, K., Ootomo, E., & Yoshino, H.
- Affiliations
- Yokufukai Hospital (JP)
- Kyorin University (JP)
- Corresponding author
- Yoshino, Hideaki
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2008-09
- Volume
- 102
- Issue
- 5
- Pages
- 573-577
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W1989396587
- Cited by
- 55
- References
- 22
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 4 · 2020: 1 · 2019: 4 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 7 · 2014: 11 · 2013: 4 · 2012: 5
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- P-wave dispersion, paroxysmal atrial fibrillation, persistent atrial fibrillation, atrial fibrillation progression, P-wave duration, electrocardiographic predictors, left atrial diameter, age as risk factor, diabetes mellitus
- MeSH terms
- Adult, Aged, Atrial Fibrillation, Echocardiography, Electrocardiography, Female, Follow-Up Studies, Heart Atria, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Regression Analysis, ROC Curve, Severity of Illness Index, Tachycardia, Paroxysmal, Time Factors, Confidence Intervals, Disease Progression
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