Abstract
Background: P wave dispersion because of its relation to the non-homogenous and interrupted conduction of sinus impulses both Intra and inter atrial is a non-invasive indicator that enables the calculation of Atrial fibrillation (AF) risk on the 12 –lead surface ECG and correlates to LV end diastolic pressure.
Aim: to study the relationship between P wave dispersion and left ventricular function was investigated in patients presenting with acute anterior myocardial infarction.
Patients and Methods: The present study included 50 patients diagnosed as acute anterior myocardial infarction and admitted at coronary care unit of Benha university hospital from January 2011 to September 2011; there mean age was 57±9.4, 88% were male and only 12% were females. All patients were subjected for full history taken included age, sex, risk factors for coronary artery disease (CAD) as diabetes smoking, hypertension. ECG was done for every patients with analysis of P wave to determine maximum P wave dispersion (P max.), minimum P wave dispersion (P min.), and the difference in between P max. and P min. called PWD. Echocardiography was done for all patients to determine LA and LV dimensions, LVEF, and also tissue Doppler performed to determine Em/Am ratio and systolic S wave by pulsed wave tissue Doppler at lateral wall of mitral valve on apical four chamber view.
Results: We found that, positive correlation between P wave dispersion and age, LA size, LVEF, tissue Doppler Em/Am ratio, and P wave duration on ECG (p < 0.001); also there was increase in only P max. in patients with systolic dysfunction (P <0.05). There is no effect of thrombolytic therapy, Beta Blocker, and ACE inhibitor on P wave dispersion and duration (P > 0.05).
Conclusion: P wave dispersion is simple noninvasive ECG test can used as predictors of occurrence of arrhythmia in patients with AMI.
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