Clinical Significance of P Wave Dispersion in Prediction of Atrial Fibrillation in Patients with Acute Myocardial Infarction

Background: p wave dispersion (pwd) is defined as the differencebetween the maximum p wave duration (pma;,:) and theminimum p wave duration (pmin) in 12-leads of the surfaceelectrocardiography. the aim of this study was to evaluate thevalues of pwd during atrial fibri ilation (a f) after acute myocardialinfarction (ami).methods: we prospectively evaluated atrial rhythms of 350patients (251 males, 99 females) at their first ami. the measurementsincluded left ventricular ejection fraction (lvef)and left atrial dimensions (lad) by means of echocardiography.on admission an ecg was obtained and repeated dailyduring hospital ization.results: fifty patients had af after ami. pma:-; was significantlyhigher (140.8(plus-minus) 18.9 rns) among patients with af thanpatients without af (106.5(plus-minus) 17.3 ms). this was also true aboutpmill (66.4(plus-minus)18.3 ms vs. 57.7(plus-minus)15.7 ms), pwd (74.4(plus-minus)20.6 rnsvs. 48.7(plus-minus)18.9 ms) and lvef (35.2(plus-minus)9.4% vs. 39.3(plus-minus)0.9%).whereas, there was no significant difference between the twogroups in respect to lad (36.5(plus-minus)7.4 mrn vs. 35.1(plus-minus) 5.9 mm)conclusion: based on the univariate analysis results, pmill,pma:-;, pwd, lvef and age were significant predictors of atrialfibrillation in patients with first acute myocardial infarction.however, multivariate analysis failed to disclose such independentpredictors for atrial fibrillation in these patients