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Europace 2002 4(3):289-293; doi:10.1053/eupc.2002.0237
© 2002 by European Society of Cardiology
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Angioplasty induced myocardial ischaemia prolongs the signal-averaged P-wave duration in single vessel coronary artery disease

Mustafa Kemal Batur1, Aylin Yildirir2, Orhan Onalan3, Giray Kabakci3, Lale Tokgozoglu3 and Ali Oto3

1Department of Cardiology, Adana Numune Hospital Turkey; 2Department of Cardiology, Baskent University Turkey; 3Department of Cardiology, Hacettepe University Turkey

AIMS: The P-wave duration (PWD) has been shown to prolong in conditions associated with elevated left ventricular end-diastolic and left atrial pressures, which also increase during transient coronary artery occlusions such as angioplasty. The aim of this study was to investigate the effects of angioplasty-induced myocardial ischaemia on signal averaged PWD in patients undergoing coronary angioplasty.

METHODS: Eighty-four consecutive adult patients with single-vessel coronary artery disease undergoing elective coronary angioplasty were included. Duration of the P wave before and during coronary angioplasty were evaluated using signal averaged P-wave analysis. Patients were classified in groups according to the artery occluded; as left anterior descending (LAD) Group, right coronary artery (RCA) Group or Others Group (which included obtuse marginal, circumflex or diagonal).

RESULTS: Patients included in the LAD, RCA and Others groups were similar with respect to clinical characteristics. The mean PWD at baseline was similar in all lesions (P> 0·05), whereas mean PWD at inflation was significantly longer in LAD Group compared with RCA (126·1±9·5 ms vs 118·7±10·4 ms, P=0·007) and Others (126·1±9·5 ms vs 116·3±8·6 ms, P< 0·001). The PWD during balloon inflation was significantly prolonged in all groups compared with baseline levels (LAD Group 126·1±9·6 ms vs 109·7±8·0 ms; RCA Group 118·7±10·4 ms vs 108·3± 8·4 ms and Others Group 116·3±8·6 ms vs 109·7±6·0 ms, all P values <0·001).

CONCLUSION: Signal-averaged PWD significantly increases during single-vessel coronary angioplasty. This increase is more pronounced for LAD lesions. However, the clinical implications of P-wave prolongation during balloon angioplasty and the value of PWD as a measure of ischaemia remains to be clarified. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.

Key Words: Angioplasty, P-wave duration, coronary artery disease

Correspondence: Aylin Yildirir, MD, Simon Bolivar Cad. No: 18/34, 06550 Cankaya Ankara/Turkey. Tel: 90 312 440 90 33; Fax: 90 312 441 35 53; E-mail: ayliny{at}ato.org.tr


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