IMR Press / RCM / Volume 22 / Issue 4 / DOI: 10.31083/j.rcm2204170
Open Access Original Research
The P wave dispersion—one pixel, one millisecond
Show Less
1 Department of Anesthesia, Critical Care and Emergency Medicine, Collegium Medicum, University in Zielona Góra, 65-046 Zielona Góra, Poland
2 Student’s Scientific Association, Department of Emergency Medical Service, Wroclaw Medical University, 50-556 Wrocław, Poland
3 Klodzko County Hospital, 57-300 Kłodzko, Poland
4 Department of Cardiology, Augusta Hospital Düsseldorf, Academic Teaching Hospital of the University Faculty of Health, 40472 Düsseldorf, Germany
5 Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wrocław, Poland
6 Department of Emergency Medical Service, Wroclaw Medical University, 50-556 Wrocław, Poland
*Correspondence: jacekzawadzkimed@gmail.com (Jacek Zawadzki)
Academic Editor: Matteo Bertini
Rev. Cardiovasc. Med. 2021, 22(4), 1633–1640; https://doi.org/10.31083/j.rcm2204170
Submitted: 26 August 2021 | Revised: 8 October 2021 | Accepted: 9 October 2021 | Published: 22 December 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

The electrophysiological activity of the heart is recorded and presented in form of electrocardiogram (ECG). In 1998 the concept of P wave dispersion as the risk factor for atrial fibrillation (AF) recurrence was introduced. It was calculated as the difference between the longest and the shortest P wave. The aim of our study is to prove that the P wave dispersion is an artifact of low accuracy in P wave measurement. The study included 186 patients (78M 108F) aged 59.7 ± 12.9 years, undergoing various electrophysiological procedures. The P wave was measured twice: first, at the paper speed of 50 mm/s, enhancement 8× (standard – imprecise) and the second time at 200 mm/s, 64–256× (precise). The imprecise measurement method resulted in different duration of all P wave parameters in comparison with precise measurement. The difference between Δ P max and Δ P min indicated a higher value for the latter parameter. It was indicated that the imprecise P wave dispersion value correlated most significantly with the maximal P wave duration, which was measured in a similar way. In contrast with the imprecise measurement method, the minimal and maximal durations of the P waves, being measured accurately, were almost identical. Using precise methodology, the P wave dispersion reaches negligible values and tends to zero. The measurements of the P wave have to be precise to assure the highest scientific and medical sincerity. The highest clinical value is related to the P wave duration.

Keywords
P wave duration
P wave dispersion
Total atrial activation time
Figures
Fig. 1.
Share
Back to top