AI Article Synopsis
- Sinus P-wave abnormalities, particularly abnormal P wave terminal force in V1 (aPTFV1), have been linked to an increased risk of thromboembolic strokes in patients with atrial fibrillation (AF) due to issues in the left atrial appendage (LAA).
- A study of 169 patients revealed that those with aPTFV1 were 2.24 times more likely to have a decreased LAA ejection velocity (LAAV < 40 cm/s) after adjusting for various risk factors.
- These findings suggest that aPTFV1 could serve as an indicator of low LAA ejection velocity, warranting further research to validate its clinical relevance.
Article Abstract
Background: Sinus P-wave abnormalities have been associated stroke in people with atrial fibrillation (AF). The majority of AF-related strokes occur from left atrial appendage (LAA) thromboembolism. Dysfunction of the left atrium (LA) and left atrial appendage (LAA) can increase rates of thromboembolic stroke. We studied whether abnormal P wave terminal force in V1 (aPTFV1) is associated with decreased LAA ejection velocity (LAAV) on transesophageal echocardiography (TEE).
Methods: We conducted a retrospective cross-sectional study reviewing patients at a tertiary care medical center who underwent TEE in sinus rhythm and had an interpretable sinus ECG within 12 months of TEE. Participants were excluded for complex congenital heart disease, age <18, cardiac transplantation, and chronic atrial pacing. Logistic regression analysis was used to estimate the odds ratios of LAAV<40 cm/s for aPTFV1.
Results: In our final cohort of 169 patients (28% of which had LAAV <40), the multivariate odds ratio of aPTFV1 for LAAV<40 cm/s after adjustment for CHADSVASc variables, heart rate during TEE, history of atrial arrhythmias, and left atrial volume index was 2.24 (95% CI of 1.13-6.00).
Conclusion: Abnromal P-wave terminal force in lead V1 is associated with low LAAV after adjustment for potential confounders. Future research is needed for validation of our findings and determination of clinical utility.
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| http://dx.doi.org/10.1016/j.jelectrocard.2021.06.011 | DOI Listing |
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