[PP.14.34] ELECTROCARDIOLOGIC P AND QRS PARAMETERS AS THE RISK SIGNS FOR FUTURE ATRIAL FIBRILLATION IN HYPERTENSIVE PATIENTS. (September 2017)

• Record Type: Journal Article
• Authors: Filipova, S.; Skultetyova, D.; Vachulova, A.; Chnupa, P.; Hlivak, P.
• Is Part Of: Journal of hypertension. Volume 35(2017)Supplement 2
• Publication Date: 2017-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000523580.25476.a4
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: The simple mode of identifying HT patients at risk for atrial fibrillation (AF) is important in practical clinical health care. Some non-invasive ECG and VCG parameters (in P and QRS waves and loops) are routinely available for ECG measurements. Especially, P wave/P loop values reflect the abnormal electrophysiologic status in atrial myocardium. Design and method: We studied 224 HT patients in sinus rhythm (SR): group I (n = 106, without documented AF), group II (n = 107, with well-documented paroxysmal AF), group III (n = 11, HT patients after successfull radiofrequence ablation of AF). ECG parameters were evaluated: (1) heart rate in SR (HR), ECG P wave and QRS, duration, non-filtered and after Hi-Res filtering: nPd, nQRSd, fPd, fQRSd, (2) VCG parameters of P, QRS axes, (3) angle between VCG loop axes P-QRS and QRS-T; (4) EchoCG parameters: LA dimension, LVEF, IVSd, PWd. Results: [1] In group II and III the non-filtered parameters (nPd, fPd) and filtered parameters (fPd, fQRSd) were significantly longer than in group I (for nPd: 135.0 ms, 145.0 ms vs.129.0 ms, p < 0.05; for nQRSd: 105.0 ms, 113.0 ms vs. 99.0 ms, p < 0.01; for fPd: 143.0 ms, 157.0 ms vs. 134.0 ms, p < 0.005; for fQRSd: 119.0 ms, 125.0 ms vs. 115.0 ms, p < 0.05). [2] P loop axis is significantly higher in group II and III vs. group I (+50.0 gr., +55.0 gr. vs.+47.0 gr.; p < 0.01). [3] Angle P-QRS is significantly higher in group II and III vs. group I (46.5 gr., 42.0 gr. vs. 24.3 gr; p < 0.005). [4] EchoCG parameters were not significantly different. (LA dimensions FOR groups. I, II, III: 40.0 mm, 42.7 mm, 42.0 mm, ns.). Conclusions: HT patients with verified pFA in documentation have more abnormal P and QRS wave/loop parameters than HT patients without history of pFA. The most informative ECG factors for possible future pFA are: fPd, fQRSd, angle between loop axes P-QRS. ECG and VCG parameters (non-filtered and especially after High-Res analysis) have the potential to improve the risk stratification for possible pFA or pFLA. These cross-sectional results is necessary to confirm with futher follow-up (after 12 months and later).