Skip Navigation

Europace 2001 3(4):299-303; doi:10.1053/eupc.2001.0187
© 2001 by European Society of Cardiology
This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (12)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Özmen, F.
Right arrow Articles by Kes, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Özmen, F.
Right arrow Articles by Kes, S.
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


ELECTROPHYSIOLOGY

Effect of balloon-induced acute ischaemia on P wave dispersion during percutaneous transluminal coronary angioplasty

F. Özmen, E. Atalar, K. Aytemir, N. Özer, T. Açil, K. Övünç, S. Aksöyek and S. Kes

Hacettepe University School of Medicine, Cardiology Departments Ankara, Turkey

Abstract

AIMS: P wave dispersion is a recent ECG marker that reflects discontinuous and inhomogeneous conduction of sinus impulses, which has been studied in a limited number of cardiac conditions. The aim of our study was to investigate the effects of angioplasty induced-ischaemia on atrial conduction abnormalities as estimated by P maximum and P dispersion.

METHODS AND RESULTS: The study consisted of 67 consecutive patients (41 men, mean age 58±11 years) with 1-vessel coronary artery disease who underwent elective single vessel coronary angioplasty (left anterior descending (LAD) coronary artery in 28 patients, the right coronary artery (RCA) in 22 patients and the left circumflex coronary artery (LCx) in 17 patients. All patients underwent 12-lead surface ECG before the first inflation (baseline) and then 60 s after intra-coronary balloon inflation. The maximum P wave duration, the minimumP wave duration, and P wave dispersion (Pd=Pmax–Pmin) were calculated from 12-lead surface ECGs.

Baseline P wave duration measurements were not significantly different among the patients with LAD, RCA and LCx coronary artery disease (P> 0·05). P dispersion and P maximum were significantly higher during balloon occlusion compared with the baseline condition in all three types of coronary dilatation procedures. However,P minimum was not found to differ between baseline and during balloon occlusion (P> 0·05).

CONCLUSION: The prolongation of P wave dispersion may be a useful and simple additional marker for myocardial ischaemia.

Key Words: P wave dispersion, P wave duration, induced-ischaemia


Correspondence: Enver Atalar, Konutkent II, C3/A Blok No. 16, Çayyolu, 06530, Ankara, Turkey. E-mail: enveratalar{at}hotmail.com


References

[1] Waggoner AD, Adyanthaya AV, Quinones MA, Alexander JK. Left atrial enlargement. Echocardiac assessment of electrocardiographic criteria. Circulation 1976; 54: 553–557.[Abstract/Free Full Text]

[2] Surawicz B. Electrocardiographic diagnosis of chamber enlargement. J Am Coll Cardiol 1986; 8: 711–724.[Abstract]

[3] Heikkila J, Hugenholtz PG, Tabakin BS. Prediction of left heart filling pressure and its sequential change in acute myocardial infarction from the terminal force of P wave. Br Heart J 1973; 35: 142–151.[Free Full Text]

[4] Chandraratna PAN and Hodges M. Electrocardiographic evidence of left atrial hypertension in acute myocardial infarction. Circulation 1973; 47: 493–498.[Abstract/Free Full Text]

[5] Josephson ME, Kastor JA, Morganroth J. Electrocardiographic left atrial enlargement. Electrophysiologic, echocardiographic and hemodynamic correlates. Am J Cardiol 1977; 39: 967–971.[Web of Science][Medline]

[6] Pande AK, Meier B, Urban P, Moles V, Dorsaz PA, Foure J. Intracoronary electrocardiogram during coronary angioplasty. Am Heart J 1992; 124: 337–341.[CrossRef][Web of Science][Medline]

[7] Bethell HJN and Nixon PGF. P wave electrocardiogram in early ischaemia heart disease. Br Heart J 1977; 39: 894–899.[Free Full Text]

[8] Myrianthefs MM, Ellestad MH, Startt-Selvester RH, Crump R. Significance of the signal-averaged P -wave changes during exercise in patients with coronary artery disease and correlation with angiographic findings. Am J Cardiol 1991; 68: 1619–1624.[CrossRef][Web of Science][Medline]

[9] Myrianthefs MM, Shanding AH, Startt-Selvester RH. Analysis of the signal-averaged P -wave duration in patients with percutaneous coronary angioplasty-induced myocardial ischemia. Am J Cardiol 1992; 70: 728–732.[CrossRef][Web of Science][Medline]

[10] Dilaveris PE, Gialafos EJ, Sideris SK, et al. Simple electrocardiographic markers for the prediction of paroxymal idiopathic atrial fibrillation. Am Heart J 1998; 135: 733–738.[CrossRef][Web of Science][Medline]

[11] Dilaveris PE, Andrikopoulos GK, Metaxas G, et al. Effects of ischemia on P wave dispersion and maximum P wave duration during spontaneous anginal episodes. Pacing Clin Electrophysiol 1999; 22: 1640–1647.[Medline]

[12] Aytemir K, Özer N, Atalar E, et al. P wave dispersion on 12-lead electrocardiography in patients with paroxysmal atrial fibrillation. Pacing Clin Electrophysiol 2000; 23: 1109–1112.[CrossRef][Medline]

[13] Özer N, Aytemir K, Atalar E, et al. P wave dispersion in hypertensive patients with paroxysmal atrial fibrillation. Pacing Clin Electrophysiol 2000; 23: 1859–1862.[Medline]

[14] Kelly AE and Gensini GG. Coronary arteriography and left heart studies. Heart Lung 1975; 4: 85–98.[Medline]

[15] James TN and Burch GE. The atrial coronary arteries in man. Circulation 1958; 17: 90–98.[Web of Science][Medline]

[16] Sigwart U, Grbic M, Goy JJ, Kappenberger L. Left atrial function in acute transient left ventricular ischemia produced during percutaneous transluminal coronary angioplasty of the left anterior descending artery. Am J Cardiol 1990; 65: 282–286.[CrossRef][Web of Science][Medline]

[17] Wijns W, Serruys PW, Slager CJ, et al. Effects of coronary occlusion during percutaneous coronary angioplasty in humans on left ventricular chamber stiffness and regional diastolic pressure-radius relations. J Am Coll Cardiol 1986; 7: 455–463.[Abstract]

[18] Mizuno K, Horiuchi K, Matui H, et al. Role of coronary collateral vessels during transient coronary occlusion during angioplasty assessed by hemodynamic, electrocardiographic and metabolic changes. J Am Coll Cardiol 1988; 12: 624–628.[Abstract]

[19] Romhilt DW and Scott RC. Left atrial involvement in acute pulmonary edema. Am Heart J 1972; 839: 328–331.[CrossRef]

[20] Nazir SA and Lab MJ. Mechanoelectric feedback in the atrium of the isolated guinea-pig heart. Cardiovasc Res 1996; 32: 112–119.[CrossRef][Web of Science][Medline]

[21] Lazar EJ, Goldberger J, Peled H, Sherman M, Frishman WH. Atrial infarction: Diagnosis and management. Am Heart J 1988; 116: 1058–1063.[Medline]

[22] Thomas NJ. Myocardial infarction and atrial arrhythmias. Circulation 1961; 24: 761–776.[Abstract/Free Full Text]


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
Eur J Heart FailHome page
K. Senen, H. Turhan, A. R. Erbay, N. Basar, A. S. Yasar, O. Sahin, and E. Yetkin
P-wave duration and P-wave dispersion in patients with dilated cardiomyopathy
Eur J Heart Fail, August 1, 2004; 6(5): 567 - 569.
[Abstract] [Full Text] [PDF]


Home page
EuropaceHome page
M. K. Batur, A. Yildirir, O. Onalan, G. Kabakci, L. Tokgozoglu, and A. Oto
Angioplasty induced myocardial ischaemia prolongs the signal-averaged P-wave duration in single vessel coronary artery disease
Europace, January 1, 2002; 4(3): 289 - 293.
[Abstract] [PDF]


This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (12)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Özmen, F.
Right arrow Articles by Kes, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Özmen, F.
Right arrow Articles by Kes, S.
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?