Correlation between the Form of Atrial Fibrillation and Width of the P Wave and Left Atrium Volume Index



Kristine Jubele1,2, Kristine Dzene2, Oskars Kalejs1,2, Aivars Lejnieks2
1 Arrhythmology, Pauls Stradins Clinical University Hospital, Latvia
2 Faculty of Internal Medicine, Riga Stradins University, Latvia

Purpose: To calrify if there is a correlation between the form of atrial fibrillation (paroxysmal or persistent) and the width of the P wave and left atrium volume index (LAVI).

Methods: We analyzed patients’ medical histories of Pauls Stradins Clinical University Hospital’s department of arrhythmology over the period from December 1, 2014 till February 28, 2015. The data from medical histories of patients who were hospitalized with atrial fibrillation were analyzed. If the patient had an electrocardiogram which was taken during sinus rhythm, the width of the P wave in II lead was measured. LAVI was taken into account only if the echocardiographic examination was done during a previous year since hospitalization. To summarize the information Microsoft Excel and IBM Statistics 20 were used.

Results:

  1. Medical histories of 139 patients hospitalized with paroxysmal or persistent atrial fibrillation were analyzed.
  2. The average width of the P wave in patients with persistent atrial fibrillation was longer (0.12s) than the average width of the P wave in patients with paroxysmal atrial fibrillation (0.092s).
  3. The average LAVI in patients with persistent atriall fibrillation was 42 ml/m2, in patients with paroxysmal atrial fibrillation it was 37 ml/m2.
  4. There was a statistically significant difference between the width of the P wave and the form of atrial fibrillation (p<0.001).
  5. There was a clear correlation between the width of the P wave and the form of atrial fibrillation (rs>0.517, p<0.001).
  6. There was no statistically significant difference (p=0.426) or correlation (rs=0.126, p=0.433) between LAVI and specific form of atrial fibrillation in the results of this study.

Conclusions:

  1. The width of the P wave has a better prognostic marker to the atrial fibrillation form than LAVI.
  2. The width of the P wave can be used to choose more agressive tactics in cardioversion strategy and treatment methods of atrial fibrillation.