Abstract
Functional and structural changes in atrial muscle constitute a
substrate for atrial fibrillation. The pathological changes in the left
atrium decrease conduction velocity and result in prolongation of the P
wave duration. The aim of the study was to assess the duration of the P
wave in patients with paroxysmal and persistent atrial fibrillation. The
study group consisted of 119 patients diagnosed with atrial
fibrillation, 57 women and 62 men, aged 65.3+/-9.4 years. There were 65
patients with paroxysmal AF and 54 with persistent AF. In this group the
electrical cardioversion was performed. The P wave duration, was
measured using electrophysiological system in all leads at paper speed
of 200 mm/s. The studied patients did not differ in term of age, gender
and comorbidities. The patients with persistent AF had longer P wave
duration (159.9+/-22.3 vs 144.6+/-17.2 ms, p<0.001), higher
glucose concentration (119.4+/-33.4 vs 108.0+/-24.6 mg/dL, p=0.015).
Those results were not influenced by the anti-arrhythmic treatment. The
persistent atrial fibrillation shows prolongation of the P wave duration
over the paroxysmal form of the arrhythmia, independently to age, gender
and anti-arrhythmic medication. The prolongation of the P wave related
to persistent arrhythmia should force the physicians to earlier
restoration of the sinus rhythm in order to its more successful long
term maintenance. Key words: P wave duration, atrial fibrillation,
diabetes mellitus, chronic kidney disease