篇名 | Coronary Artery Dominance May Predict Future Risk of Atrial Fibrillation |
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卷期 | 34:4 |
作者 | Abdullah Nabi Aslan 、 Serdal 、 Ahmet Kasapkara 、 Murat Can Güney 、 Serkan Sivri 、 Engin Bozkurt |
頁次 | 344-351 |
關鍵字 | Atrial fibrillation 、 Coronary artery dominance 、 Holter electrocardiogram 、 P wave dispersion 、 P wave duration 、 MEDLINE 、 SCI 、 Scopus |
出刊日期 | 201807 |
DOI | 10.6515/ACS.201807_34(4).20180326B |
Background: Ischemia of the atria and conductive system of the heart results in greater atrial electrophysiological changes and propensity for atrial fibrillation. P wave duration and dispersion have been proposed to be useful for the prediction of paroxysmal atrial fibrillation (PAF). This study aimed to investigate the effect of coronary artery dominance on P wave duration and dispersion. Methods: The study population included 194 patients with left dominant circulation (LDC) and 200 age- and gendermatched controls with right dominant circulation (RDC) and without coronary artery disease based on invasive coronary angiography findings. P wave dispersion (PWD) was defined as the difference between themaximum and minimum Pwave duration. Arrhythmiaswere identified by 24-hour Holter electrocardiogram at 3 years of follow-up. Results: PWD was significantly prolonged in the patients with LDC compared to the controls with RDC (p = 0.001). Therewere positive correlations between PWD and age (r: 0.502, p = 0.009), left ventricular mass (LVM) (r: 0.614, p = 0.001), LVM index (r: 0.727, p < 0.001) and left atrium (LA) diameter (r: 0.558, p = 0.003) in the LDC group. Multivariate logistic regression analysis showed that age, LVM index, LA diameter and LDC were independent predictors of prolonged PWD. At 3 years of follow-up, 7 (3.9%) patients with LDC and 1 (0.5%) patient with RDC had PAF in Holter electrocardiogram (p < 0.001). Conclusions: LDC could lead to an increased risk of atrial fibrillation through prolonged PWD. We recommend following up these patients to assess the development of atrial fibrillation.