Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul;45(7):832-838.
doi: 10.1111/pace.14541. Epub 2022 Jun 2.

Paced P-wave duration as a significant predictor for atrial high-rate episodes in patients with cardiac implantable electronic devices

José M Rubio Campal  1 , Alberto Sánchez Arjona  1 , Camila S García Talavera  1 , Loreto Bravo Calero  1 , Carla Lázaro Rivera  1 , Francisco Díaz Cortegana  1 , José Tuñón  1 , Adrián M Baranchuk  2
Affiliations

Paced P-wave duration as a significant predictor for atrial high-rate episodes in patients with cardiac implantable electronic devices

José M Rubio Campal et al. Pacing Clin Electrophysiol. 2022 Jul.

Abstract

Background: Atrial pacing (AP) can unmask or aggravate a preexisting interatrial block (IAB). The aim of our study was to determine whether AP is associated with the development of atrial high-rate episodes (AHRE) during follow-up.

Methods: Patients with dual-chamber cardiac implantable electronic devices (CIEDs), no previous documented atrial fibrillation, and with a 6-month minimum follow-up were included. In all patients, sinus and paced P-wave duration were measured. AHRE was defined as an episode of atrial rate ≥225 bpm with a minimum duration of 5 min, excluding those documented during the first 3 months after implantation.

Results: A total of 220 patients were included (75 ± 10 years, 61% male). After a mean follow-up of 59 ± 25 months, 46% of patients presented AHRE. Mean paced P-wave duration was significantly longer than the sinus P-wave duration (154 ± 27 vs. 115 ± 18 ms; p < .001). Sinus and paced P-waves were significantly longer in those who developed AHRE (sinus: 119 ± 20 vs. 112 ± 16; p = .006; paced: 161 ± 29 vs. 148 ± 23; p < .001). A paced P-wave ≥160 ms was the best predictor of AHRE, especially those lasting >24 h (odds ratio [OR] 4.2 [95% confidence interval (CI)] [1.6-11.4]; p = .004).

Conclusions: AP significantly prolongs P-wave duration and is associated with further development of AHRE. A paced P-wave ≥160 ms is a strong predictor of AHRE and should be taken into consideration as a new definition of IAB in the presence of AP.

Keywords: P-wave duration; atrial high-rate episodes; cardiac implantable electronic devices; interatrial block.

PubMed Disclaimer

References

REFERENCES

    1. Bayes de Luna A, Fort de Ribot R, Trilla E, et al. Electrocardiographic and vectorcardiographic study of interatrial conduction disturbances with left atrial retrograde activation. J Electrocardiol. 1985;18:1-13.
    1. Bayes de Luna A, Cladellas M, Oter R, et al. Interatrial conduction block and retrograde activation of the left atrium and paroxysmal supraventricular tachyarrhythmia. Eur Heart J. 1988;9:1112-1118.
    1. Bayes de Luna A, Platonov P, Cosio FG, et al. Interatrial blocks. A separate entity from left atrial enlargement: a consensus report. J Electrocardiol. 2012;45:445-451.
    1. Masso-van Roessel A, Escobar-Robledo LA, Dégano IR, et al. Analysis of the association between electrocardiographic P-wave characteristics and atrial fibrillation in the REGICOR study. Rev Esp Cardiol (Engl Ed). 2017;70:841-847.
    1. Lemery R, Birnie D, Tang AS, et al. Normal atrial activation and voltage during sinus rhythm in the human heart: an endocardial and epicardial mapping study in patients with a history of atrial fibrillation. J Cardiovasc Electrophysiol. 2007;18:402-408.

LinkOut - more resources