Vol 9: Interatrial conduction disturbance in postoperative atrial fibrillation: a comparative study of P-wave dispersion and Doppler myocardial imaging in cardiac surgery.Report as inadecuate



 Vol 9: Interatrial conduction disturbance in postoperative atrial fibrillation: a comparative study of P-wave dispersion and Doppler myocardial imaging in cardiac surgery.


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This article is from Journal of Cardiothoracic Surgery, volume 9.AbstractObjective: Disturbances of interatrial conduction have been proposed as one of the contributing mechanisms of postoperative atrial fibrillation AF. P-wave dispersion has been recognized as a sensitive tool for detecting interatrial conduction disturbances. Doppler myocardial imaging DMI has been validated as a non-invasive tool to indirectly reflect electrical atrial activation and therefore is used in this study to detect possible interatrial electromechanical disturbances after cardiac surgery. Methods: 30 patients 23 men, age 62 ± 1 years admitted for coronary bypass surgery with no prior history of AF were included in this investigation. Echocardiography and electrocardiograms ECG were obtained on the day before and after surgery. In addition to standard echocardiography, DMI-loops were acquired from the apical window. The following time intervals were derived off-line from the free right atrial RA, left atrial LA lateral and LA posterior wall: onset P-wave to start P to A’start, to peak P to A’peak and to end of atrial deformation total electromechanical activity. These intervals were compared to each other and to P-wave dispersion derived from the recorded ECGs. Results: All patients were in sinus rhythm during their postoperative assessment, but 11 patients presented episodes of AF within the first three postoperative days. Atrial electromechanical activation was earliest in the RA and latest in the lateral LA. In patients with AF, P-wave dispersion was significantly prolonged postoperatively mean: +18.6 ms; 95% confidence interval CI: 12.1–25.2 ms; p 



Author: Hatam, Nima; Aljalloud, Ali; Mischke, Karl; Karfis, Elias A; Autschbach, Rudiger; Hoffmann, Rainer; Goetzenich, Andreas

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