BACKGROUND: Patients with hypertrophic cardiomyopathy (HCM) have a high incidence of atrial fibrillation. They also have a longer P-wave duration than healthy controls, indicating conduction alterations. Previous studies have demonstrated orthogonal P-wave morphology alterations in patients with paroxysmal atrial fibrillation. In the present study, the P-wave morphology of patients with HCM was compared with that of matched controls in order to explore the nature of the atrial conduction alterations. METHODS AND RESULTS: A total of 65 patients (45 men, mean age 49 +/- 15) with HCM were included. The control population (n = 65) was age and gender matched (45 men, mean age 49 +/- 15). Five minutes of 12-lead ECG was recorded. The data were subsequently transformed to orthogonal lead data, and unfiltered signal-averaged P-wave analysis was performed. The P-wave duration was longer in the HCM patients compared to the controls (149 +/- 22 vs 130 +/- 16 ms, P < 0.0001). Examination of the P-wave morphology demonstrated changes in conduction patterns compatible with interatrial conduction block of varying severity in both groups, but a higher degree of interatrial block seen in the HCM population. These changes were most prominent in the Leads Y and Z. CONCLUSION: The present study suggests that the longer P-wave duration observed in HCM patients may be explained by a higher prevalence of block in one or more of the interatrial conduction routes.
BACKGROUND:Patients with hypertrophic cardiomyopathy (HCM) have a high incidence of atrial fibrillation. They also have a longer P-wave duration than healthy controls, indicating conduction alterations. Previous studies have demonstrated orthogonal P-wave morphology alterations in patients with paroxysmal atrial fibrillation. In the present study, the P-wave morphology of patients with HCM was compared with that of matched controls in order to explore the nature of the atrial conduction alterations. METHODS AND RESULTS: A total of 65 patients (45 men, mean age 49 +/- 15) with HCM were included. The control population (n = 65) was age and gender matched (45 men, mean age 49 +/- 15). Five minutes of 12-lead ECG was recorded. The data were subsequently transformed to orthogonal lead data, and unfiltered signal-averaged P-wave analysis was performed. The P-wave duration was longer in the HCM patients compared to the controls (149 +/- 22 vs 130 +/- 16 ms, P < 0.0001). Examination of the P-wave morphology demonstrated changes in conduction patterns compatible with interatrial conduction block of varying severity in both groups, but a higher degree of interatrial block seen in the HCM population. These changes were most prominent in the Leads Y and Z. CONCLUSION: The present study suggests that the longer P-wave duration observed in HCM patients may be explained by a higher prevalence of block in one or more of the interatrial conduction routes.
Authors: Fredrik Holmqvist; Pyotr G Platonov; Scott McNitt; Slava Polonsky; Jonas Carlson; Wojciech Zareba; Arthur J Moss Journal: Ann Noninvasive Electrocardiol Date: 2010-01 Impact factor: 1.468
Authors: Fredrik Holmqvist; Pyotr G Platonov; Jonas Carlson; Wojciech Zareba; Arthur J Moss Journal: Ann Noninvasive Electrocardiol Date: 2009-07 Impact factor: 1.468
Authors: Richard Petersson; Hilde M Berge; Gard F Gjerdalen; Jonas Carlson; Fredrik Holmqvist; Kjetil Steine; Pyotr G Platonov Journal: Ann Noninvasive Electrocardiol Date: 2014-02-12 Impact factor: 1.468
Authors: Fredrik Holmqvist; Pyotr G Platonov; Scott D Solomon; Richard Petersson; Scott McNitt; Jonas Carlson; Wojciech Zareba; Arthur J Moss Journal: Ann Noninvasive Electrocardiol Date: 2013-11 Impact factor: 1.468