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Evaluation of the Relationship between Atrial Septal Aneurysm and Cardiac Arrhythmias via P-Wave Dispersion and Signal-Averaged P-Wave Duration


Address for correspondence: Onur Sinan Deveci, M.D., Kecioren Research and Training Hospital, Department of Cardiology, Ankara, Turkey. Fax: +90 312 2213276; E-mail:


Objective: The aim of the study was to investigate the relationship between atrial septal aneurysms (ASAs) and cardiac arrhythmias via signal-averaged P-wave duration (SAPWD) and P-wave dispersion (Pd).

Methods: Sixty-six patients with ASA served as the study group (group 1; 28 men and 38 women; mean age, 34 ± 10 years) and 62 healthy volunteers served as the control group (group 2; 29 men and 33 women; mean age, 31 ± 8 years) in the current study. ASAs were diagnosed by transthoracic echocardiography based on the criteria of a minimal aneurysmal base of ≥15 mm; and an excursion of ≥10 mm. All subjects were evaluated by 24-hour Holter monitoring, 12 lead body surface electrocardiogram for P-wave analysis, and signal-averaged electrocardiogram for P-wave duration (PWD).

Results: There was no significant difference between the study and control groups in terms of age, gender, left atrium diameter, and left ventricular ejection fraction. Supraventricular arrhythmias (SVAs) were detected in 29 patients with ASA (43.9%) and 5 controls (8.1%; P < 0.001). The mean Pd in patients with ASA was significantly longer compared to the control group (14.1 ± 8 ms vs 7.0 ± 2.9 ms; P < 0.001). Similarly, the mean SAPWD in group 1 was significantly longer compared to group 2 (127.4 ± 17.6 ms vs 99.8 ± 12.3 ms; P < 0.001).

Conclusion: Prolonged SAPWD and Pd were determined to indicate electrical disturbances in the atrial myocardium, and predict the increase in the prevalence of SVA in patients with ASA.

Ann Noninvasive Electrocardiol 2010;15(2):157–164