Prolonged P-wave duration is associated with increased left atrial volume and delayed atrial conduction assessed by electro-anatomic mapping in patients with atrial fibrillation

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of electrocardiology Pub Date : 2026-03-01 Epub Date: 2026-01-26 DOI:10.1016/j.jelectrocard.2026.154201

Tomoyuki Kabutoya, Hisaki Makimoto, Kazunori Anno, Yuko Torigoe- Kurosu, Yoshifumi Kimura, Takafumi Okuyama, Hiroaki Watanabe, Ayako Yokota, Masashi Kamioka, Tomonori Watanabe, Takahiro Komori, Yasushi Imai, Kazuomi Kario

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引用次数: 0

Abstract

Background

Atrial remodeling contributes to atrial fibrillation through structural and electrical alterations. Prolonged P-wave duration indicates conduction delay, while 3D mapping quantifies left atrial (LA) volume and conduction time.

Methods

This study enrolled 27 patients with atrial fibrillation (mean age 63 ± 10 years, 18 men) who underwent catheter ablation. Post-ablation 3D mapping was performed to assess atrial conduction time and LA volume. LA volume was also measured by transthoracic echocardiography. Electrocardiograms for analysis were obtained the following day while all patients were in sinus rhythm. Standard 12‑lead ECGs were recorded, and P-wave duration was digitally measured in each lead; the maximum value (Pmax) was used for analysis. Atrial conduction time and LA volume were compared between patients with Pmax ≥140 ms and those with Pmax <140 ms.

Results

Pmax was significantly correlated with LA conduction time (R = 0.51, p = 0.016), total atrial conduction time (R = 0.62, p < 0.001), and the LA volume index (R = 0.48, p = 0.034). Patients with Pmax ≥140 ms showed delayed conduction and a larger LA volume index compared with those with Pmax <140 ms (LA conduction time 137.3 ± 41.0 vs. 104.5 ± 19.9, p = 0.010; total atrial conduction time 178.8 ± 40.0 vs. 140.8 ± 24.2, p = 0.007; LA volume index 73.7 ± 8.4 vs. 53.6 ± 16.0 mL/m², p = 0.014). Moreover, Pmax was significantly correlated with the LA volume index measured by echocardiography (R = 0.52, p = 0.013).

Conclusions

Prolongation of Pmax on electrocardiography was significantly associated with delayed atrial conduction and increased LA volume as measured by electro-anatomic mapping.

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心房颤动患者p波持续时间延长与左心房容积增加和心房传导延迟有关

背景：心房重构通过结构和电的改变导致心房颤动。p波持续时间延长表明传导延迟，而3D测绘量化左房（LA）体积和传导时间。方法27例房颤患者（平均年龄63±10岁，男性18例）行导管消融治疗。消融后进行三维绘图以评估心房传导时间和左心室容积。经胸超声心动图测量LA容积。第二天，所有患者均处于窦性心律时，进行心电图分析。记录标准12导联心电图，并以数字方式测量每个导联的纵波持续时间；取最大值（Pmax）进行分析。结果spmax与左房传导时间（R = 0.51, p = 0.016）、总心房传导时间（R = 0.62, p < 0.001）、左房容积指数（R = 0.48, p = 0.034）显著相关。与Pmax≥140 ms的患者相比，Pmax≥140 ms的患者传导延迟，LA容积指数更大（LA传导时间137.3±41.0∶104.5±19.9,p = 0.010；心房总传导时间178.8±40.0∶140.8±24.2,p = 0.007； LA容积指数73.7±8.4∶53.6±16.0 mL/m2, p = 0.014）。此外，Pmax与超声心动图测量的LA容积指数显著相关（R = 0.52, p = 0.013）。结论心电图Pmax延长与电解剖测得的心房传导延迟和LA容积增大有显著相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of electrocardiology 医学-心血管系统

CiteScore

2.70

自引率

7.70%

发文量

152

审稿时长

38 days

期刊介绍： The Journal of Electrocardiology is devoted exclusively to clinical and experimental studies of the electrical activities of the heart. It seeks to contribute significantly to the accuracy of diagnosis and prognosis and the effective treatment, prevention, or delay of heart disease. Editorial contents include electrocardiography, vectorcardiography, arrhythmias, membrane action potential, cardiac pacing, monitoring defibrillation, instrumentation, drug effects, and computer applications.