- 作者：Hideki Hayashi ; MD ; PhD ; hayashih@belle.shiga-med.ac.jp" class="auth_mail" title="E-mail the corresponding author ; Minoru Horie ; MD ; PhD horie@belle.shiga-med.ac.jp" class="auth_mail" title="E-mail the corresponding author
- 关键词：Biphasic P wave ; Atrial fibrillation ; Electrocardiography ; Conduction ; Prognosis
- 刊名：Journal of Arrhythmia
- 出版年：2015
- 出版时间：December 2015
- 年：2015
- 卷：31
- 期：6
- 页码：376-380
- 全文大小：2480 K
Methods
Digital analysis of retrospectively recorded 12-lead electrocardiograms was performed to select patients with a biphasic P wave (positive/negative) in lead II from a database of 114,334 patients. Characteristics of the P wave in the inferior leads associated with incidence of AF were determined. Receiver operating characteristic curves dichotomized P wave variables were measured in each lead.
Results
A total of 141 patients (77 men; mean age, 64±19 years) were enrolled in this study. Twenty-nine (20.6%) patients developed AF (AF group) vs. 112 (79.6%) who did not (non-AF group) during a follow-up period of 50±62 months. The amplitude of the initial P wave portion in lead II was significantly larger in the AF group when compared with the non-AF group (77.3±77.0 µV vs. 51.0±30.1 µV, p=0.003), while the amplitude of the terminal P wave portion in lead III was significantly decreased in the AF group when compared with the non-AF group (−70.6±41.3 µV vs. −89.1±38.1 µV, p=0.024). The duration of the initial P wave portion in lead III was significantly longer in the AF group when compared with the non-AF group (52.7±34.6 ms vs. 35.8±30.4 ms, p=0.011). Multivariate Cox proportional-hazards analysis confirmed that the increased duration of the initial P wave portion in lead III (≥71 ms) was independently associated with AF development (hazard ratio 2.90, 95% confidence interval 1.16–7.11, p=0.02).
Conclusion
The analyses of the biphasic P wave in the inferior leads suggest that the development of AF could be attributed to increased atrial slow conduction.