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- Title
The electrocardiographic characteristics of the P-wave with incomplete Bachmann's bundle block in patients with atrial fibrillation.
- Authors
Mercik, Jakub Szymon; Unkell, Malte; Marinov, Maxim; Wolff, Peter Stephan; Radziejewska, Jadwiga; Gajek, Jacek; Sławuta, Agnieszka
- Abstract
Introduction. The structural and functional changes in atrial myocardium create a substrate for atrial fibrillation (AF). The pathophysiology includes enlargement of the cavities and replacing the cardiomyocytes with connective tissue. That slows down the conduction velocity and creates focal conduction block zones and slow conduction areas promoting the re-entrant circuits. The described changes influence the duration and amplitude of the P-wave in the electrocardiography. Materials and methods. The study group consisted of 54 patients diagnosed with AF. There were 19 women and 35 men, aged 65.8 ± 10.0 years. 22 patients had paroxysmal AF, in sinus rhythm during the examination and 32 had persistent AF, in whom the direct current cardioversion was performed to achieve sinus rhythm. Results. In patients with persistent atrial fibrillation the P-wave duration after the restoration, the sinus rhythm was significantly longer in comparison to patients with paroxysmal atrial fibrillation (159.2 ± 14.3 vs. 171.2 ± 16.6 ms, p = 0.006). The patients with persistent AF showed higher positive amplitude in lead V1 as well as higher negative amplitude than patients with paroxysmal AF; positive amplitude: 0.053 ± 0.023 vs. 0.084 ± 0.040 mV, p = 0.002, negative amplitude: 0.045 ± 0.018 vs. 0.075 ± 0.037 mV, p = 0.001. Conclusions. In patients with incomplete Bachmann's bundle block and atrial fibrillation, the duration of the P-wave is prolonged, more in the persistent arrhythmia group. The P-wave duration and morphology correlate with the interatrial conduction disturbances. The P-wave morphology changes indicate the causal relationship of AF rather with interatrial conduction delay than with left atrial hypertrophy.
- Subjects
ATRIAL fibrillation; P-waves (Electrocardiography); HEART cells; HYPERTROPHY; HEART beat measurement
- Publication
Folia Cardiologica, 2020, Vol 15, Issue 5, p343
- ISSN
2353-7752
- Publication type
Article
- DOI
10.5603/FC.2020.0049