Prolonged P wave duration in adults with secundum atrial septal defect:: a marker of delayed conduction rather than increased atrial size?
Prolonged P wave duration in adults with secundum atrial septal defect:: a marker of delayed conduction rather than increased atrial size?
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DOI：
10.1093/europace/eum214
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发表时间：
2007-11-01
期刊：
影响因子：
6.1
通讯作者：
Olsson, S. Bertil
中科院分区：
文献类型：
--
作者：
Thilen, Ulf;Carlson, Jonas;Olsson, S. Bertil
目的虽然心房。纤维性颤动是心房的常见并发症。中隔的对于分泌型ASD，其潜在机制知之甚少。心房传导障碍，表现为延长的P波持续时间，已被认为是心律失常的一种基质。未修复的ASD中P波延长已通过常规ECG证实，但未通过更复杂的方法证实。本研究的目的是用高分辨率P波信号平均心电图（PSA-ECG）分析P波时限和形态，并探讨潜在的心房肌电活动。方法和结果P波信号平均心电图获得了35例成人患者（年龄53 +/- 15岁）与ASD，并与相同数量的性别和年龄匹配的健康对照。右心房和左心房。ASD组通过超声心动图评估大小。ASD组的P波持续时间显著长于对照组（148 +/- 16 vs. 128 +/- 15 ms，P < 0.0001）。P波形态在患者和对照组之间没有显著差异。P波时限与房性心律失常无明显关系。结论房间隔。在成人中的缺陷的特征在于延长的P波持续时间，表明心房延迟。传导，这与心房的扩大无关，而是与传导延迟有关。这种情况的性质和可能的可逆性需要进一步调查。
Aims Although atrial. fibrillation is a frequent complication of an atrial. septal. defect (ASD) of the secundum type, the underlying mechanisms are poorly understood. Atrial conduction disturbances, manifested as a prolonged P-wave duration, have been suggested as a substrate for arrhythmia. Prolongation of the P-wave in unrepaired ASD has been demonstrated by means of the conventional ECG, but not by more sophisticated methods. The aim of the study was to anatyse P-wave duration and morphology by high-resolution P-wave signal-averaged ECG (PSA-ECG) and to investigate potential atrial. mechano-electrical interactions in adults with an unrepaired ASD.Methods and results P-wave signal-averaged-ECG was obtained in 35 adult patients (age 53 +/- 15 years) with ASD and compared with an equal number of sex- and age-matched healthy controls. Right and left atrial. sizes were assessed by echocardiography in the ASD group. P wave duration was significantly longer in the ASD group than in control subjects (148 +/- 16 vs. 128 +/- 15 ms, P < 0.0001). P-wave morphology did not differ significantly between patients and controls. There was no clear relation between P-wave duration and atrial. size.Conclusion Atrial septal. defect in the adult is characterized by a prolonged P-wave duration, indicating delayed atrial. conduction, which is not related to the enlargement of the atria but rather to conduction delay. The nature and potential reversibility of this warrant further investigation.