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M A Baturova, A Svensson, J H Svendsen, H Bundgaard, V Sherina, J Carlson, P G Platonov, P2506
Long-term evolution of P wave indices in arrhythmogenic right ventricular cardiomyopathy indicates atrial involvement, European Heart Journal, Volume 39, Issue suppl_1, August 2018, ehy565.P2506, https://doi.org/10.1093/eurheartj/ehy565.P2506Close - Share Icon Share
Extract
Introduction: Little is known about atrial involvement in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVC), however earlier studies reported atrial fibrosis affecting propagation of excitation in the atria. P-wave terminal force in lead V1 (PTF-V1) is an electrocardiographic (ECG) marker of left atrial remodeling, while flattening of P waves expressed as reduction of P-wave area (Parea) in the right precordial leads may also reflect development of fibrosis in the right atrium. Longitudinal studies assessing changes of P-wave indices in ARVC patients over time are lacking.
Purpose: We aimed to assess long-term evolution of ECG markers of atrial involvement in ARVC patients.
Methods: ARVC patients with a definite diagnosis according to Task Force 2010 criteria from three tertiary care centers participating in the Nordic ARVC Registry (n=71, median age at ARVC diagnosis 43 [IQR 32–56] years, 23 (32%) female). All ECG recordings in the hospital catchment areas from 1988 were extracted from the regional electronic ECG databases and digitally processed using Glasgow algorithm. Recordings representing tachycardia >100 b.p.m. or pacing were excluded, which left 1569 ECGs available for analysis, i.e. on average 22 ECG's per patient. The impact of age and gender on the time-dependent changes in P-wave parameters were assessed using linear mixed effect models with random patient-specific intercept using age, gender and categorized time expressed in years from the age of ARVC diagnosis, which was defined as 0, and assessed using Wald and F-test. Mean values of the following P-wave parameters were compared at 5-year intervals before and after ARVC diagnosis: PTF-V1, Parea in leads V1 and V2 and P-wave duration (PWD).
