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The Significance of P Wave Duration and P Wave Dispersion for Risk Assessment of Atrial Tachyarrhythmias in Patients with Corrected Tetralogy of Fallot

Authors

  • Olgu Hallioglu M.D.,

    1. Hacettepe University, Faculty of Medicine, Department of Pediatrics, Section of Pediatric Cardiology and Cardiology, Ankara, Turkey
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  • Kudret Aytemir M.D.,

    1. Hacettepe University, Faculty of Medicine, Department of Pediatrics, Section of Pediatric Cardiology and Cardiology, Ankara, Turkey
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  • Alpay Celiker M.D.

    1. Hacettepe University, Faculty of Medicine, Department of Pediatrics, Section of Pediatric Cardiology and Cardiology, Ankara, Turkey
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Address for reprints: Olgu Hallioglu, M.D., Mersin University Faculty of Medicine, Department of Pediatrics, Section of Pediatric Cardiology, 33079 Zeytinlibahce/Mersin, Turkey. Fax: +90-324-3288742; E-mail: ohallioglu@mersin.edu.tr

Abstract

Background: The aim of the present study was to determine the potential role of P wave duration and P wave dispersion for risk assessment of atrial tachyarrhythmias in patients with corrected tetralogy of Fallot (ToF).

Methods: The maximum P wave duration, minimum P wave duration, and the P wave dispersion from the 12-lead surface electrocardiogram of the patients and controls were measured. Electrophysiological study was performed only in the patient group.

Results: The study group consisted of 25 patients with corrected ToF with a mean age of 16.4 ± 4.25 years and 25 age-matched healthy control subjects. Patients underwent repair at a mean age of 4.6 ± 3.41 years (range: 1–19), and the mean duration of follow-up of 11.8 ± 1.7 years (range: 9–15) after surgery. On electrophysiological study sinus node dysfunction was detected in 3 patients (12%), atrial tachyarrythmias—atrial flutter or fibrillation—in 5 patients (20%), both sinus node dysfunction and atrial flutter in 1 patient (4%), and AV conduction delay in 1 patient (4%). P wave dispersion is significantly higher in patients with atrial tachyarrhythmia inducible by electrophysiological study than in other patients (P < 0.05). A P wave dispersion value of >35 ms has a high predictive accuracy (sensitivity = 83% and specificity = 89%) for inducible atrial tachyarrhythmia in patients with corrected tetralogy of Fallot.

Conclusion: P wave dispersion is an easily measured electrocardiographic marker with a good sensitivity and specificity for predicting atrial arrhythmias in patients after correction of ToF.

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