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Review
. 2016 Jul-Aug;16(4):126-133.
doi: 10.1016/j.ipej.2016.10.002. Epub 2016 Oct 20.

P-wave dispersion: an update

Andrés Ricardo Pérez-Riera  1 , Luiz Carlos de Abreu  2 , Raimundo Barbosa-Barros  3 , José Grindler  4 , Acácio Fernandes-Cardoso  4 , Adrian Baranchuk  5
Affiliations
Review

P-wave dispersion: an update

Andrés Ricardo Pérez-Riera et al. Indian Pacing Electrophysiol J. 2016 Jul-Aug.

Abstract

P-wave dispersion (PWD, Pd or Pdis) is a noninvasive electrocardiographic (ECG) marker for atrial remodeling and predictor for atrial fibrillation (AF). PWD is defined as the difference between the widest and the narrowest P-wave duration recorded from the 12 ECG leads. Increased P-wave duration and PWD reflect prolongation of intraatrial and interatrial conduction time with lack of a well-coordinated conduction system within the atrial muscles, with inhomogeneous, asynchronic, pro-inflammatory and anti-inflammatory effect mediated by interleukin-6 (IL-6) in patients with the CG + GG genotype IL-6 -634C/G polymorphism [1] and discontinuous propagation of sinus impulses mainly between the left and right atria, interstitial/extracellular fibroblast activation and collagen deposition with fibrosis (via TGF-β) in atrial tissue, insufficient blood supply, significant not isotropic myoelectric activity, and thin wall thickness and consequent expansion tendency all well-known electrophysiological characteristics in patients with atrial arrhythmias and especially paroxysmal atrial fibrillation (PAF) [2].

Keywords: Interatrial block; Intraatrial block; P-wave dispersion; P-wave duration; Paroxysmal atrial fibrillation.

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Figures

Fig. 1
Fig. 1
Main action points of ROS.
Fig. 2
Fig. 2
Appropriate measurement of P-wave duration.
Fig. 3
Fig. 3
Outline of atrial activation in advanced interatrial block (A-IAB), third degree or complete IAB.
See this image and copyright information in PMC

References

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